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Jefferson County Syringe Exchange Program (SEP)
Annual Report 2013
Jefferson County Public Health has provided a Syringe Exchange Program (SEP) since 2000
as part of a State effort to reduce the risk of HIV and other blood-borne infections among
injection drug users, their families and communities. SEP services include access to clean
syringes, disposal of used syringes, prevention supplies, risk reduction education, and referral
services. Education includes verbal and printed information on HIV, hepatitis, STDs, overdose
prevention, encouraging one time use of needles, health alerts (for example, wound botulism
and recent heroin overdoses/deaths), and immunizations. Internal referrals include STD, HIV,
and Hepatitis 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.
JCPH funded the SEP from 2000 – 2011 with State HIV prevention dollars. The CDC
guidelines shifted in 2011 to focus funding for HIV Prevention Programs on high risk
populations based on local HIV prevalence. Jefferson County is classified as a low prevalence
county so it does not qualify for funding. There was no State funding available for 2012 or 2013
and there is none for 2014. There is some discussion at the State level about finding a way to
reinstitute funding for SEPs statewide.
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 utilization increased in 2013, with 185 visits, up from
150 visits in 2012. The number of syringes dispensed was 24,596, up from 17,405 in 2012.
The number of IDU prevention materials dispensed increased from 11,535 to 15,984. See
tables and graphs on following pages.
The State Public Health Lab provides a limited number of free HIV tests for high risk clients.
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. In the last quarter of 2013, staff began encouraging
uninsured clients to sign up for health insurance through www.wahealthplanfinder.org and
offered appointments to assist clients.
Funding for State and federal programs for free Hepatitis C testing for high risk clients ended in
2012. Three free Hepatitis C tests were provided in 2013 with the remaining test kits. The
State is planning a new Hepatitis C testing program that will be available some time in 2014.
Twenty doses of free Hepatitis A/B vaccine were received from the State in August 2013.
Twelve doses of vaccine were administered in 2013.
Jefferson County SEP Clinics/Demographics
SEP
Visits1
New
Clients
Returning
Client
Visits1
Female
Client
Visits1
Male
Client
Visits1
2013 185 28 157 115 70
2012 150 18 132 NA NA
2011 142 19 123 NA NA
2010 81 13 68 NA NA
2009 65 12 53 NA NA
2008 68 6 64 NA NA
2007 65 9 56 NA NA
2006 54 8 50 NA NA
2005 36 6 30 NA NA
2004 64 12 48 NA NA
2003 63 9 55 NA NA
2002 41 11 29 NA NA
2001 16 6 9 NA NA
2000 14 3 7 NA NA
Note:
1Represents duplicate clients
14 16
41
63 64
36
58 65 70
65
81
142 150
185
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
24,596
-
5,000
10,000
15,000
20,000
25,000
30,000
35,000
-
20
40
60
80
100
120
140
160
180
2000 2001 2002 2003200420052006 2007 2008 2009 2010 2011 2012 2013
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Syringe Exchange Utilization, 2000-2013
Jefferson County Washington
Number of client visits
Number of syringes
exchanged
2011 – 2013 SEP Clinic Participant Visits by Zip Code
2011 – 2013 SEP Clinic Participant Reported Syringe Use
2011 – 2013 SEP Clinic Participant Secondary Exchange
59%
29%
11%
1%
60%
34%
5%1%
59%
38%
3%0%
0%
10%
20%
30%
40%
50%
60%
70%
98368 Other within
Jefferson Cty
Outside
Jefferson Cty
Unknown
2011
2012
2013
49%
22%
3%
26%
64%
12%
2%
22%
64%
21%
1%
14%
0%
10%
20%
30%
40%
50%
60%
70%
Each syringe
used once
Each syringe
used 2-5 times
Each syringe
used 6+ times
Unknown
2011
2012
2013
17%18%
38%
22%
5%
32%
9%
49%
6%4%
31%
11%
47%
10%
1%
0%
10%
20%
30%
40%
50%
60%
No
secondary
exchange
Exchanging
for one other
person
Exchanging
for 2-5 other
people
Exchanging
for 6+ other
people
Unknown
2011
2012
2013
Materials Distributed by Jefferson County SEP
Syringes
Exchanged
IDU
Prevention
Materials1
Condoms/
Latex
Barriers2
HIV
Tests
Offered
Educational
Materials3
Referral
Information4
Outreach
Education5
2013 24,596 15,984 377 90 18 129 105
2012 17,405 11,535 406 49 28 128 90
2011 17,726 16,512 319 41 10 142 86
2010 9,156 11,024 102 36 7 67 29
2009 14,044 7,098 271 31 26 51 33
2008 21,330 7,941 140 27 32 35 32
2007 24,585 9,988 20 22 18 23 N/R7
2006 17,905 9,000 0 2 3 2 N/R
2005 13,716 7,611 20 0 6 11 N/R
2004 18,060 7,265 228 N/O6 48 11 N/R
2003 9,222 1424 800 N/O 42 18 N/R
2002 4,206 1,026 427 N/O 50 NA N/R
2001 2,076 3 14 N/O 9 5 N/R
2000 506 11 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 This 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.
3 Educational Materials include information on hepatitis, HIV, STDs, health alerts (ex. wound botulism, overdose), care of
abscesses, street drugs, tattoo safety, needle reuse, IDU safety, domestic violence, immunizations.
4 Referrals: Internal referrals include STD, HIV and Hepatitis 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.
5 Outreach education is defined as face-to-face education on blood borne pathogens, risk reduction methods, safe injecting
practices, vein care, and other as needed.
6 N/O: Not offered
7 N/R: Not reported
2014 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 others about SEP.
Continue to educate clients on the importance and rational of using each syringe one time only.
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.
Encourage uninsured clients to sign up for health insurance through
www.wahealthplanfinder.org
Resume offering free Hepatitis C testing when State has new program in place; continue
offering Hepatitis A & B vaccine.
Offer free Tdap vaccine through the G.I.F.T. or state programs.
Continue dialog with clients regarding improvement of SEP services
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.
2/14/2014