Abstract
Syringe exchange programs (SEPs) are effective structural interventions for HIV prevention among persons who inject drugs. In 2000, a buffer zone policy (the 1000 Foot Rule) was implemented in Washington, DC, that prohibited SEP operations within 1000 feet of schools. We examined changes in the amount of legal SEP operational space over time. We used data pertaining to school operations and their approximate physical property boundaries to quantify the impact of the 1000 Foot Rule on legal SEP operational space from its implementation in 2000–2013. Adherence to the 1000 Foot Rule reduced SEP operational space by more than 50 % annually since its implementation. These findings demonstrate the significant restrictions on the amount of legal SEP operational space in Washington, DC, that are imposed by the 1000 Foot Rule. Changing this policy could have a significant impact on SEP service delivery among injectors.
Highlights
In the United States (US), an estimated 2.6 % of the population has ever injected drugs [1]
Adherence to the 1000 Foot Rule reduced syringe exchange programs (SEPs) operational space by more than 50 % annually since its implementation. These findings demonstrate the significant restrictions on the amount of legal SEP operational space in Washington, District of Columbia (DC), that are imposed by the 1000 Foot Rule
Since the 1980s, the number of new human immunodeficiency virus (HIV) infections attributed to injection drug use (IDU) has declined, yet new cases are still diagnosed among persons who inject drugs (PWID) both domestically and globally [3]
Summary
In the United States (US), an estimated 2.6 % (approximately 6,612,488 persons) of the population has ever injected drugs [1]. This is a concerning estimate given the disproportionate burden of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections among injectors [2]. Since the 1980s, the number of new HIV infections attributed to injection drug use (IDU) has declined, yet new cases are still diagnosed among persons who inject drugs (PWID) both domestically and globally [3]. While the HIV transmission rates from IDU exposure have declined, HCV transmission continues to be a concern. Research has found that, during a 2010 survey of DC PWID, 90 % of participants indicated they were HCV positive [8]
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