Points of Perspective : Research Report on the Federal Needle Exchange Program in Canada
[Introduction]: "People who are incarcerated have long been recognized as disproportionately affected by HIV and hepatitis C, with injection drug use a major contributing factor to the spread of these viruses (OHTN, 2014). In response, prison-based needle and syringe programs have provided people who are incarcerated with access to sterile injection equipment in more than 60 prisons in over 10 countries since 1992 (HRI, 2020; UNODC, 2014). Evaluations over the past three decades have consistently shown that such programs reduce new HIV and hepatitis C infections, reduce injection-related injuries such as abscesses, reduce the sharing of needles, and do not increase in-prison drug use overall (for example, see Lazarus et al., 2018; Moazen et al., 2020; UNODC, 2014).
Prison-based needle and syringe programs tend to employ one of the following four models: distribution via automatic dispensing machines; distribution by health care staff; distribution by peers (i.e. trained fellow prisoners); and/ or distribution by external organizations that specialize in harm reduction (UNODC, 2014). Each model has advantages and disadvantages with regard to anonymity, confidentiality, accessibility, feasibility, ease of implementation, cost, and effects on interpersonal relationships, for example between people who use drugs in prison, and with other prisoners, prison staff, and external staff (PHAC, 2006; Stöver & Nelles, 2003; van der Meulen et al., 2016).
Yet, despite ample empirical evidence demonstrating the effectiveness of needle and syringe programs, the federal Correctional Service of Canada (CSC) refused for decades to implement this essential prison harm reduction program. After years of inaction, in 2012 the HIV Legal Network along with Steve Simons, a man formerly incarcerated in a federal prison, and three HIV organizations — PASAN, CATIE, and CAAN — launched a constitutional challenge to compel CSC to provide people in prison with access to sterile injection equipment.”
