In summary, the new studies contribute substantially to the strength of the data showing the following effects of effective syringe exchange programs: 

	A decrease in new HIV seroconversions (infections);
	An increase in the numbers of injection drug users referred to and retained in substance abuse treatment; and
	Well documented opportunities for multiple prevention services and referral and entry into medical care.

The data indicate that the presence of a syringe exchange program does not increase the use of illegal drugs among participants in syringe exchange programs, and in many cases, a decrease in injection frequency has been observed among those attending these programs. (Bold added)

Other highlights from the report:

	Laboratory studies show prolonged viability of HIV in used needles (> 4 weeks), providing strong biologic rationale for removal of used drug injection equipment from circulation.
	Syringe exchange programs consistently attract persons with highest risk profiles for HIV infection and severe drug use, and are successful in referring syringe exchange program clients into detoxification and substance abuse treatment programs.
	Syringe-exchange-program-referred clients have similar rates of retention in substance abuse treatment as individuals from standard referral sources, despite more severe baseline drug use and high-risk lifestyles.
	Clients participating in syringe exchange programs have decreased reuse of contaminated syringes and reduced sharing of injection equipment.
	The data indicate that the presence of a syringe exchange program does not increase the use of illegal drugs among participants, and in many cases, a decrease in injection frequency has been observed among those attending these programs.
	Provision of sterile injection equipment through syringe exchange programs and pharmacy access is cost-effective; one HIV infection can be prevented for one third the cost of medical care for an infected person.
	The scientific evidence accumulated to date provides a basis on which municipalities that are heavily affected by an HIV epidemic driven by injection drug use should consider syringe exchange programs as a tool for the identification, referral and retention of active users of injection drugs into these services, as part of a comprehensive HIV prevention plan.

These highlights are taken from a review of scientific literature on needle exchange programs and an annotated bibliography on needle exchange programs prepared by the Surgeon General.

Statement from Congresswoman Nancy Pelosi releasing the Surgeon General's review, April 13, 2000.

Letter from Secretary of Health and Human Services Donna E. Shalala submitting the Surgeon General's review to Congresswoman Nancy Pelosi.