Abstract
The results confirmed previous studies that have shown that needle and syringe exchange programs (NSEP) attenders are likely to report less HIV risk of this having a meaningful impact on behavior than those not attending NSEP. This can be seen when we compare NSEP injecting drug users (IDU) with IDU from both time 1 and time 2. The results also reflect the ethnographic fieldwork accounts of outreach workers at the NSEP and the first authors observations and discussions with NSEP clients in the field. The results also highlight issues for further health promotion work such as drug preparation and condom use. Although not without limitations it is important that we can demonstrate improvements in risk behavior in order to encourage the necessary political support and resource allocation essential to a successful roll-out strategy. Currently a number of towns and districts in Sverdlovsk are planning new harm reduction interventions targeting drug users. (excerpt)
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