Syringe Exchange Programmes in the Context of Harm Reduction

injecting drug users (idu) are particularly vulnerable to hepatitis c virus (hcv), human immunode？ciency virus (hiv) and other bloodborne infections as result of sharing contaminated injecting equipment. providing access and encouraging utilization of all sterile injection paraphernalia for idu is considered a fundamental component of an effective harm reduction programme. twenty-？ve years after the implementation of the ？rst of？cial syringe exchange programme (sep) in the world, providing idu with access to sterile injection equipment remains a serious challenge in both developed and developing countries. the capacity of any given sep to reach idu is dependent on its particular characteristics. sep are extremely diverse in their modes of operation, injecting equipment dispensation policies and availability of other services provided. different modalities for improving injecting equipment delivery, such as conventional sep in ？xed-sites, community pharmacy-based distribution, dispensing machines and outreach programmes, have been developed to improve access to and utilization of sterile injecting equipment and to increase idu choice. understanding barriers and preferences to sep access of idu is essential to providing services which meet their needs.