Cadernos de Saúde Pública
On-line version ISSN 1678-4464
Print version ISSN 0102-311X
FONSECA, Elize Massard da; RIBEIRO, José Mendes; BERTONI, Neilane and BASTOS, Francisco I.. Syringe exchange programs in Brazil: preliminary assessment of 45 programs. Cad. Saúde Pública [online]. 2006, vol.22, n.4, pp.761-770. ISSN 1678-4464. http://dx.doi.org/10.1590/S0102-311X2006000400015.
The present study aims to evaluate the current operation of Brazilian syringe exchange programs (SEP). After consulting national and regional networks of people working in projects/ programs aiming to reduce drug-related harm, we identified 134 potential participant programs. Unfortunately, only 45 SEPs answered a survey, even after repeated attempts. The survey addressed: coverage, funding, procurement of basic supplies, managerial capacity, and the local political environment. Findings were triangulated with in-depth interviews with key informants. The main findings included: satisfactory adherence to the initiatives and adequate documentation, but deficiencies in terms of coverage and monitoring, and uneven procurement of resources. Program personnel work mostly on a provisional basis, despite the efforts of local coordinators. Most programs are funded by the National STDs/AIDS Program. A comprehensive agenda aiming to improve current operations should include: concerted efforts to improve local and regional databanks, incentives/sanctions toward full accountability of initiatives carried by the programs, and a genuine culture of monitoring and evaluation.
Keywords : Syringe-Exchange Programs; Acquired Immunodeficiency Syndrome; Intravenous Substance Abuse.