This document discusses different models for distributing syringes through syringe exchange programs (SEPs). It describes fixed location exchanges, mobile/street based exchanges, home delivery in both urban and rural areas, integrating into existing organizations, peer-based exchanges, collaborations, and utilizing volunteers to clean up neighborhoods and distribute disposal information. The best model depends on factors like cost, staffing, geography, and politics, and multiple models can be used to increase access and reduce disease transmission.

1. METHODS OF SYRINGE DELIVERY
Deciding what’s best for your program
SEP’s use many different models to distribute syringes to their target populations. Some
exchanges use exclusively one model; others use several.
Which model a program uses depends on a number of factors including cost,
staff/volunteer availability, geographic context (e.g. urban vs. rural), and political climate.
Using multiple models can increase access to injectors and help decrease transmission of
HIV and Hepatitis C.
Fixed Location
A building houses the syringe exchange. This could be a storefront, an office, or other
similar space.
STRENGTHS
•Respite from street activity/safe space
•Protection from weather
•Room for ancillary services
•Out of view of local residents and businesses
•Privacy for program participants
LIMITATIONS
•Higher overhead and maintenance
•Participants have to come to you
•Limited hours of operation
•Can become the focus of community opposition
•Difficult to adjust to changes in the scene and neighborhood development
Mobile/Street Based
Vehicle based exchange; driving to already established exchange sites. In urban
areas, foot or bike­based mobile exchange.
STRENGTHS
•Flexibility if the drug scene or neighborhood changes
•Easier negotiation with neighborhood if they know you are not a permanent fixture
•Informal or low threshold if actually on the street or in a park
•Reaches harder to reach IDUs
LIMITATIONS
•Harder to deliver ancillary services than with a fixed site
•Weather can dissuade participants from accessing services
•Van involves higher overhead because of insurance, upkeep, driver, etc.
Contents of Methods of Syringe Delivery PowerPoint Presentation 1
Homeless Youth Alliance’s San Francisco Needle Exchange 2010

2. Home Delivery/Urban
Delivering supplies to where a person lives (or another agreed upon site) in the city,
such as SRO rooms, scattered site housing, shooting galleries. Can happen on a
regular schedule, or by appointment via cell phone or pager.
STRENGTHS
•Safer for participants
•Potential for large exchanges and increased return rates
LIMITATIONS
•Participant needs to be at home
•Invasion of privacy
•Safety of workers and or volunteers
Home Delivery Rural
Provision of services where a person lives in the country or the suburbs. This is often
done by word of mouth once the initial contact is made. Also done by appointment.
STRENGTHS
•Safer for participants
•Potential for large exchanges and increased return rates
LIMITATIONS
•Can involve a lot of driving, resulting in high overhead.
•Participant needs to be at home
•Integrating into pre‐existing structure
Integrating into pre­existing structure
An organizations add a syringe exchange into their ongoing services
STRENGTHS
•Established organizational infrastructure and participant base
•Multiple ways of getting syringes to participants, depending on the type of services
provided by agency
LIMITATIONS
•Staff are often resistant to new programs and ideas
•Staff are often resistant or are not appropriate especially if the agency follows a
abstinence approach and is not familiar with harm reduction
Contents of Methods of Syringe Delivery PowerPoint Presentation 2
Homeless Youth Alliance’s San Francisco Needle Exchange 2010

3. Peer­based Exchange
Also called satellite or secondary exchange. Participants exchange with their peers
after being trained and supplied by syringe access agency.
STRENGTHS
•Peer knowledge of drugs, drug use, and the local scene
•Increases access to syringes for isolated injectors who do not or cannot access traditional
services
•Can easily be incorporated as part of all delivery models
•Empowers participants
LIMITATIONS
•Cost and time of training and supervision of SSEs
•Possible conflicting identities as peer worker and community member
•If SSEs disengage (i.e. quit using, move, get arrested) people lose their access to supplies
Collaboration
Partner agencies that provide other type of services in the community (e.g. social,
shelter, youth, etc.) but also provide SEP services at their site.
STRENGTHS
•May attract different populations than parent exchange
•Increases accessibility in terms of location, time, gender, age, etc.
•May offset operational cost of the parent SEP
LIMITATIONS
•Can be difficult to enforce policies of parent exchange with the policies of the partner
agency
Another Idea / Suggestion
Neighborhood and community safety concerns will inevitably arise. It is better to
address it proactively rather than reactively.
The Crew, composed of 10‐15 volunteers (mostly the kids), are first trained on how to
properly dispose of trash, recyclables and used syringes, then walk the streets of Haight
Ashbury and Golden Gate Park and execute the mission of working to make the
neighborhood safer. While doing the Clean Up’s the crew distributes awareness materials
to possible users or finders of syringes that describe the proper methods of disposal.
Contents of Methods of Syringe Delivery PowerPoint Presentation 3
Homeless Youth Alliance’s San Francisco Needle Exchange 2010