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COMMUNITY HEALTH ENVIRONMENTAL HEALTH
DEVELOPMENTAL DISABILITIES WATER QUALITY
MAIN: (360) 385-9400 MAIN: (360) 385-9444
FAX: (360) 385-9401 FAX: (360) 379-4487
JEFFERSON COUNTY PUBLIC HEALTH
615 Sheridan Street Port Townsend Washington 98368
www.jeffersoncountypublichealth.org
Jefferson County Syringe Exchange Program (SEP)
Annual Report 2012
Jefferson County has provided a Syringe Exchange Program (SEP) since 2000 as part of a
state and regional effort to reduce the risk of HIV infection in our communities. This program,
also, reduces the risk of Hepatitis A, B and C infections through risk reduction education and
referrals, an important part of each visit. Education includes verbal and printed information on
hepatitis, HIV, STDs, health alerts (for example, wound botulism and recent heroin
overdoses/deaths), care of abscesses, street drugs, tattoo safety, intravenous drug use safety
(encouraging one time use of needles), and immunizations. Internal referrals include STD, HIV,
Hepatitis B & C screening and counseling, tuberculosis screening, family planning and
immunizations. External referrals include drug and alcohol treatment, medical care, mental
health care, domestic violence, food, clothing and shelter.
HIV services have been funded in the past by the state and federal government and HIV case
management services have been provided by Clallam County Health Department in recent
years. CDC guidelines focus on funding HIV Prevention Programs for high risk populations
based on HIV prevalence in the local area. Jefferson County is classified as a low prevalence
county; thereby, not qualifying for federal funding. There was no state funding available for 2012
and there is none for 2013.
The syringe exchange program success is not easily measured in disease prevention numbers
but the number of clients seen and syringes exchanged reflects the disease transmission
prevention capacity of this program. SEP continues to be well utilized with 142 visits in 2011
and 150 visits in 2012. The number of syringes dispensed in 2012 was 17,405, down very
slightly from 17,726 in 2011. The number of IDU prevention materials dispensed increased from
11,024 to 11,535. See tables and graphs on following pages.
In 2012, the State Public Health Lab provided a limited number of free HIV tests for high risk
clients and will continue to do so in 2013. Though there is no state funding for staff time for HIV
counseling and testing services, JCPH staff will continue to provide this service for low income
high risk clients with no medical coverage. Others requesting testing will be tested through the
Quest lab and the cost of the testing will be billed to the client/insurance.
Funding for the state and federal programs for free Hepatitis C testing and free Hepatitis A & B
vaccine for high risk clients ended in 2012. For 2013, we have seven Hepatitis C test kits
remaining and vaccine for eight clients.
Jefferson County SEP Clinics/Demographics
Clinics
Offered
Clinics
Visits1
Drop-In
Visits1
New
Clients
Returning
Client
Visits1
2012 98 40 110 18 132
2011 100 22 120 19 123
2010 103 6 75 13 68
2009 102 4 61 12 53
2008 99 6 64 6 64
2007 97 4 61 9 56
2006 126 u/k 542 8 50
2005 119 u/k 352 6 30
2004 136 u/k 522 12 48
2003 119 u/k 582 9 55
2002 108 u/k 332 11 29
2001 98 u/k 142 6 9
2000 33 u/k 132 3 7
Note: 1Represents duplicate clients 2Clinic and drop-in visit
14 16
41
63 64
36
58
65 70 65
81
142
150
506
2,076
4,206
9,222
18,060
13,716
17,905
24,585
21,133
14,044
9,156
17,726
17,405
-
5,000
10,000
15,000
20,000
25,000
30,000
35,000
-
20
40
60
80
100
120
140
160
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
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Syringe Exchange Utilization, 2000-2012
Jefferson County Washington
Number of client visits
Number of syringes
exchanged
59% 29%
11% 1%
2011 SEP Clinic Participant
Visits by Zip Code
98368
Other within
Jefferson Cty
Outside Jefferson
Cty
Unknown
60%
34%
5% 1%
2012 SEP Clinic Participant Visits
by Zip Code
98368
Other within
Jefferson Cty
Outside
Jefferson Cty
Unknown
64%
12%
2% 22%
2012 SEP Clinic Participant
Syringe Use
Each syringe
used once
Each syringe used 2-5 times
Each syringe
used 6+ times
Unknown
49% 22%
3% 26%
2011 SEP Clinic Participant
Syringe Use
Each syringe
used once
Each syringe
used 2-5 times
Each syringe
used 6+ times
Unknown
32%
9%
49%
6%
4%
2012 SEP Clinic Participant
Secondary Exchange
No secondary exchange
Exchanging for one other person
Exchanging for 2-5 other people
Exchanging for 6+
other people
Unknown
17%
18%
38%
22%
5%
2011 SEP Clinic Participant
Secondary Exchange
No secondary
exchange
Exchanging for
one other person
Exchanging for 2-5
other people
Exchanging for 6+
other people
Unknown
Materials Distributed by Jefferson County SEP
Syringes Exchanged IDU Prevention
Materials1
Prevention Kits2 Condoms/ Latex
Barriers3
HIV Tests
Offered
Educational Materials4 Referral Information5 Outreach Education6
2012 17,405 11,535 1 406 49 28 128 90
2011 17,726 16,512 1 319 41 10 142 86
2010 9,156 11,024 4 102 36 7 67 29
2009 14,044 7,098 6 271 31 26 51 33
2008 21,330 7,941 0 140 27 32 35 32
2007 24,585 9,988 0 20 22 18 23 N/R8
2006 17,905 9,000 0 0 2 3 2 N/R
2005 13,716 7,611 0 20 0 6 11 N/R
2004 18,060 7,265 6 228 N/O7 48 11 N/R
2003 9,222 1424 38 800 N/O 42 18 N/R
2002 4,206 1,026 35 427 N/O 50 NA N/R
2001 2,076 3 9 14 N/O 9 5 N/R
2000 506 11 15 33 N/O 10 2 N/R
Notes 1 IDU Prevention Materials include: Tourniquets, cookers, cottons, sterile water, sharps containers, alcohol preps, antibiotic
ointment, band aids and sterile pads for wounds, tape, hygiene items (toothbrush, soap, comb, and razor). Individual items are given
on an as needed basis. 2 Prevention Kits include: sample quantity of tourniquets, cookers, cottons, sterile water, sharps containers, alcohol preps, antibiotic
ointment, band aids, hygiene items (toothbrush, soap, comb, and razor) 3This number is for condoms dispensed in SEP only and does not account for the number of condoms SEP clients pick up in the
lobby where there is a free supply available.
4 Educational Materials include information on hepatitis, HIV, STDs, health alerts (ex. wound botulism), care of abscesses, street
drugs, tattoo safety, needle reuse, IDU safety, domestic violence, immunizations 5Referrals: Internal referrals include STD, HIV and Hepatitis B & C screening and counseling, tuberculosis screening, family
planning and immunizations. External referrals include drug treatment, medical care, mental health care, domestic violence, food,
clothing and shelter. 6Outreach education is defined as face-to-face education on safe injecting practices, vein care, blood borne pathogens, risk
reduction methods, and other as needed 7N/O: Not offered 8N/R: Not reported
2013 Goals
Continue anonymous, safe services to reduce the risk of HIV infection in our communities by
promoting revisits by clients and to encourage clients to tell their friends and contacts about SEP.
Continue dialog with clients regarding improvement of SEP services.
Continue to explore options to start a program for overdose prevention and naloxone distribution.
Continue to inform clients at each visit of resources available at JCPH and in the community.
Continue to offer free HIV testing and counseling at each visit through the state laboratory for low
income high risk clients without medical coverage.
Continue to offer free Hepatitis C testing and counseling and Hepatitis A & B vaccine at each visit
while supplies last.
Offer free Tdap (tetanus, diphtheria and pertussis) vaccine through the G.I.F.T. or state
programs.
Provide each new client with a prevention kit, condoms, educational materials and referral
information.
Continue to educate clients on the importance and rational of using each syringe one time only.
Prioritize supplies to be stocked, keeping only those deemed necessary to maintain safe
practices among IDU clients. Inform clients of alternative safe materials, such as using pop/soda
bottles for the collection of used needles in lieu of sharps containers.
Data Source: Jefferson County Public Health SEP Intake Records
Prepared by Carol Burwell, PHN, Jefferson County Public Health 01/18/13