Prison Needle Exchange: Lessons from a Comprehensive Review ...

the prisoners who were injecting, a lack of anonymity and of
confidentiality in the service, and the fact that needle exchange
was only available during office hours. According to Dr
Bodrug, “To make the needle exchange genuinely anonymous,
we recruited eight secondary exchange volunteers to work
throughout the penal colony. The advantage is a much higher
degree of trust and confidentiality.” 207 This decision inaugurated
stage two of the program.
Under stage two of the program, eight peer volunteers were
trained to provide harm-reduction services in four different
sites in the prison. Two peer volunteers were assigned to work
at each site and they are available on a 24-hour basis, as the
sites are based within the prison living units (barracks-style
accommodations, with 70 or more men living and sleeping in
the same large room). The activities and programs are carried
out in cooperation with the prison physician. The role of the
physician is to act as project supervisor and as a link between
the peer volunteers, prison staff, and Health Reform in Prisons personnel. In the first nine
months of 2002, 65% to 70% of people known to inject drugs in the prison were accessing
the program through the peer volunteers. In 2002, the peer volunteers in PC18 exchanged
7150 syringes. 208
Harm reduction and
HIV-prevention information,
Prison Colony 18, Branesti, Moldova.
(photo: Elena Vovc)
Evolution of Syringe Exchange in Prison Colony 18:
Needles Exchanged Annually 209
YEAR SYRINGES EXCHANGED
2000 115
2001 4350
2002 7150
In addition to one-for-one syringe exchange, peer volunteers also distribute condoms, disinfectants,
antiseptic pads, and razors for shaving. They also provide harm-reduction and HIVprevention
information, including information on safer injecting and post-injection problems.
The team of peer volunteers changes every year.
Expansion to other prisons
Based upon the success of the pilot project, on 16 May 2002 Order
52 authorized the implementation of a second needle exchange project
in Prison Colony 4, a men’s institution in Cricova housing 1200
prisoners. This program is also peer based and uses three peer volunteers.
During the first few months of the project, approximately
40 to 45 prisoners used the exchange. By the end of the year the
number of prisoners accessing the needle exchange program had
increased to approximately 160. 210 In PC4, the peer volunteers
exchanged 7555 syringes during 2002. 211
Peer volunteers also
distribute condoms,
disinfectants, antiseptic pads,
and razors for shaving.
Review of International Evidence 39