Abstract
An examination was conducted of three Tasmanian cohorts of injecting drug users interviewed before the introduction of needle exchanges, during the operation of illegal exchanges and after the introduction of legal exchanges. The drugs reported as used were comparable with reports from Perth and Sydney samples. There are clear downward trends for both males and females toward reduced sharing of injecting equipment and increased use of new equipment which begin when the illegal exchanges were operating and accelerate when the number of exchanges increased and became legal. The use of bleach to clean equipment also increases in the 4-year period. There was a much higher use of open fires to dispose of equipment than has been reported elsewhere. These results strongly suggest that needle exchanges do lead to reduced sharing and to less needles in public places; vital outcomes if AIDS and hepatitis are to be contained.