Syringe exchange programs in Brazil: preliminary assessment of 45 programs

Abstract

The present study aims to evaluate the current operation of Brazilian syringe exchange pro grams (SEP). After consulting national and re gional networks of people working in projects/ programs aiming to reduce drug-related harm, we identified 134 potential participant pro grams. Unfortunately, only 45 SEPs answered a survey, even after repeated attempts. The survey addressed: coverage, funding, procurement of basic supplies, managerial capacity, and the lo cal political environment. Findings were trian gulated with in-depth interviews with key in formants. The main findings included: satisfac tory adherence to the initiatives and adequate documentation, but deficiencies in terms of cov erage and monitoring, and uneven procurement of resources. Program personnel work mostly on a provisional basis, despite the efforts of local coordinators. Most programs are funded by the National STDs/AIDS Program. A comprehensive agenda aiming to improve current operations should include: concerted efforts to improve lo cal and regional databanks, incentives/sanc tions toward full accountability of initiatives carried by the programs, and a genuine culture of monitoring and evaluation.