Can difficult-to-reuse syringes reduce the spread of HIV among injection drug users?

by Jonathan P. Caulkins, Edward Harris Kaplan, Peter Lurie, Thomas O'Connor, Sung-Ho Ahn


Purchase Print Copy

 FormatList Price
Add to Cart Paperback11 pages Free

Sharing of syringes by injection drug users is a principal means by which the human immunodeficiency virus (HIV) is spread. Some have suggested that distributing syringes that are difficult to reuse (DTR) would slow the spread of HIV. The authors developed a simple mathematical model that describes how changes in the numbers of DTR syringes or regular syringes consumed over the course of a fixed number of injections affect the proportion of injections that are potentially infectious and, thus, the transmission of HIV. It suggests that increasing consumption of either type of syringe will reduce the proportion of potentially infectious injections, but that, per syringe added, the reduction is always greater if a regular rather than a DTR syringe is added. Similarly, introducing a certain number of DTR syringes and simultaneously reducing the consumption of regular syringes by the same number will increase, not decrease, the proportion of infectious injections. DTR syringes are more expensive than regular syringes, so there is little justification for substituting them for regular syringes.

Originally published in: Interfaces, v. 28, no. 3, May-June 1998, pp. 23-33.

This report is part of the RAND Corporation Reprint series. The Reprint was a product of the RAND Corporation from 1992 to 2011 that represented previously published journal articles, book chapters, and reports with the permission of the publisher. RAND reprints were formally reviewed in accordance with the publisher's editorial policy and compliant with RAND's rigorous quality assurance standards for quality and objectivity. For select current RAND journal articles, see External Publications.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.