US Syringe Exchange Programs: Federal support "primarily symbolic"?

http://www.ncbi.nlm.nih.gov/pubmed/22420810

Am J Public Health. 2012 Mar 15. [Epub ahead of print]

Life After the Ban: An Assessment of US Syringe Exchange Programs' Attitudes About and Early Experiences With Federal Funding.

Green TC, Martin EG, Bowman SE, Mann MR, Beletsky L.

Source

At the time of the study, Traci C. Green was with the Alpert School of Medicine of Brown University and the Division of General Internal Medicine, Rhode Island Hospital, Providence. Erika G. Martin was with the Rockefeller College of Public Affairs and Policy and the Nelson A. Rockefeller Institute of Government, University at Albany-State University of New York. Sarah E. Bowman and Marita R. Mann were with the Division of General Internal Medicine, Rhode Island Hospital. Leo Beletsky was with the Division of Global Health at University of California San Diego.

Abstract

Objectives. 

We aimed to determine whether syringe exchange programs (SEPs) currently receive or anticipate pursuing federal funding and barriers to funding applications following the recent removal of the long-standing ban on using federal funds for SEPs. 

Methods. 

We conducted a telephone-administered cross-sectional survey of US SEPs. Descriptive statistics summarized responses; bivariate analyses examined differences in pursuing funding and experiencing barriers by program characteristics. 

Results. 

Of the 187 SEPs (92.1%) that responded, 90.9% were legally authorized. Three received federal funds and 116 intended to pursue federal funding. Perceived federal funding barriers were common and included availability and accessibility of funds, legal requirements such as written police support, resource capacity to apply and comply with funding regulations, local political and structural organization, and concern around altering program culture. Programs without legal authorization, health department affiliation, large distribution, or comprehensive planning reported more federal funding barriers. 

Conclusions. 

Policy implementation gaps appear to render federal support primarily symbolic. In practice, funding opportunities may not be available to all SEPs. Increased technical assistance and legal reform could improve access to federal funds, especially for SEPs with smaller capacity and tenuous local support.