[The efficacy of needle exchange programs in the prevention of HIV and hepatitis infection among injecting drug users].

BACKGROUND HIV infection has become one of the major public health problems of our time. An estimated 33.2 million people lived worldwide with HIV in 2007. Injecting drug users are the most at risk group of HIV infection in many regions of the world. Injecting drug use became the primary route of infection in Western- and Central Europe, also in North America and Australia, and dominated from the beginning of the epidemic in Eastern Europe and Central Asia. GOALS Identifying drug users as risk groups has evoked a series of intervention possibilities, of which the authors introduce and assess the effectiveness of needle and syringe exchange programs. METHODS We evaluated a literature search by the use of MEDLINE, PsycINFO and Web of Science databases. RESULTS After reviewing the scientific literature the authors conclude that needle and syringe exchange programs are an effective way of reducing risky behaviors related to injecting drug use, hence they are effective in reducing the spread of HIV among injecting drug users and the population. The authors introduce the literature related to the effectiveness of various kinds of programs for distributing sterile injecting equipment. CONCLUSION Besides various kinds of prevention programs and harm reduction measures, when adopted to the given populations needs and socio-cultural circumstances, the providing of needle and syringe programs are an indispensable condition of successfully preventing the spread of HIV.