Harmonizing disease prevention and police practice in the implementation of HIV prevention programs: Up-stream strategies from Wilmington, Delaware
1 Brandywine Counseling and Community Services Inc, 2713 Lancaster Avenue, Wilmington, DE, 19805, USA
2 Bryn Mawr Graduate School of Social Work, Social Work Research, 100 Airdale Road, Bryn Mawr, PA, 19010, USA
3 Network for Public Health Law, 101 East Weaver Street, Suite G-7, Carrboro, NC, 27510, USA
4 American Civil Liberties Union Foundation of Delaware, 100 W. 10th Street, Suite 603, Wilmington, DE, 19801, USA
5 Santos Architecture and Graphic Design, 452 S. Atlantic Avenue, Pittsburgh, PA, 15224, USA
6 Northeastern University School of Law, Bouve College of Health Sciences, 400 Huntington Ave, Boston, MA, 02115, USA
Harm Reduction Journal 2012, 9:17 doi:10.1186/1477-7517-9-17Published: 16 May 2012
Improving access to sterile injection equipment is a key component in community-based infectious disease prevention. Implementation of syringe access programs has sometimes been complicated by community opposition and police interference.
In 2006, the Delaware legislature authorized a pilot syringe exchange program (SEP). A program designed to prevent, monitor, and respond to possible policing and community barriers before they had a chance to effect program implementation and operation. A program designed to prevent, monitor, and respond to these barriers was planned and implemented by a multidisciplinary team of legal practitioners and public health professionals.
We report on an integrated intervention to address structural barriers to syringe exchange program utilization. This intervention employs community, police and client education combined with systematic surveillance of and rapid response to police interference to preempt the kinds of structural barriers to implementation observed elsewhere. The intervention addresses community concerns and stresses the benefits of syringe exchange programs to officer occupational safety.
A cohesive effort combining collaboration with and educational outreach to police and community members based on the needs and concerns of these groups as well as SEP clients and potential clients helped establish a supportive street environment for the SEP. Police-driven structural barriers to implementation of public health programs targeting populations engaged in drug use and other illicit behavior can be addressed by up-stream planning, prevention, monitoring and intervention strategies. More research is needed to inform the tailoring of interventions to address police-driven barriers to HIV prevention services, especially among marginalized populations.