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The Social Context of Needle Exchange and User Self-Organization in San Francisco: Possibilities and Pitfalls

In order to halt the spread of human immunodeficiency virus (HIV) among injection drug users (IDUs), innovative intervention programs such as Prevention Point Needle Exchange have been established. As a means toward understanding the possibility of establishing User Self-Organizations, we reviewed pertinent literature and analyzed qualitative data that we collected at two syringe exchange sites in San Francisco. Based on our analysis, we discovered that IDUs in San Francisco are committed to working with the needle exchange program and with other IDUs to help decrease the transmission of HIV. We also discovered that the political and social context in the United States may not as easily foster user organizations as in Europe and Australia. We believe that in order to foster user organizations and broaden its harm-reduction approach, Prevention Point will have to confront internal and external contradictions to serve as a conduit for necessary social and political change.