The Madison County Health Department operates a Syringe Exchange Program (SEP) to reduce the spread of blood borne diseases such as Hepatitis C and HIV among people who inject drugs (PWID) by providing a scientifically proven public health service that adopts and utilizes the best practices established for harm reduction in this population. Its goals include: -Address the spread of blood borne diseases among PWID through best practices in harm reduction. -Reduce the amount of used syringes disposed of in the community. -Act as an access point for individuals to obtain referrals and information on drug treatment and rehabilitation, health service, insurance enrollment, counseling, and other social services that may be available. -Provide education on prevention of opioid overdose and education and instruction on the proper use of naloxone/Narcan (either in person or by referral to a pharmacy that offers naloxone/Narcan without a prescription), to reduce overdoses and increase emergency treatment for those who may be in settings where its use may be required to prevent death. -Safeguard all participants and assure that PWIDs are treated with respect and without stigma. -Assure that all issues that require a referral for services are addressed in a systematic and confidential manner. Services at the SEP include: -Clean injection equipment. -Hepatitis C, HIV, STD and pregnancy testing available at MCHD clinic locations and/or if operating in a mobile unit, rapid HIV and Hepatitis C testing with referrals for other testing as needed if space permits. -Hepatitis A vaccination is available at the SEP site. Referral for other immunizations, including the annual influenza vaccine, that are available at MCHD clinic locations. -Education regarding Hepatitis B, Hepatitis C, and HIV/AIDS transmission, risk reduction, sexually transmitted diseases, condoms, and safe sex information. Proper syringe disposal, including the expectation that participants will return used needles to the SEP for proper disposal. Instructions to return used syringes will also be included in the Participant Rights and Responsibilities. -A strict one-for-one exchange model will be employed that provides SEP participants with the same number of sterile syringes that the participant brings in for disposal. For example, if the participant disposes of 14 used syringes at the MCHRSEP, then she/he receives 14 new, sterile syringes in return. -Referrals for those who request health services or treatment services.