Bleach-mediated disinfection (BMD) of needles and syringes (NS) has been advocated as a risk-reduction intervention against HIV among injection drug users (IDUs). The effect of needle exchange on the BMD practices of 176 NS-sharing IDUs was evaluated. IDUs were randomly assigned to either 1) Pharmacy Sales Condition, access to NS via legal sales of nonprescription NS; or 2) Needle Exchange Condition, with additional access to NS via an experimental needle exchange program. Repeated measures analysis revealed a main effect of time on BMD, no effect of assignment condition, and no time by assignment interaction. Logistic regression revealed IDUs who traded sex for money or drugs were less likely to practice BMD, and IDUs who reported a reduced number of sex partners were more likely to practice BMD. Future interventions should incorporate behavioral BMD components and address the concerns of those who trade sex for money or drugs.
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