The Exchange, a Harm Reduction Syringe Exchange Program (HRSEP) is to slow the spread of disease (i.e. HIV and Hepatitis C) and increase access to health care and substance abuse treatment among intravenous drug users.  The HRSEP decreases the spread of disease with the exchange of contaminated needles for sterile needles; promotes health through education of rotating injection sites and wound care, on-site counseling or referrals to counseling and treatment services, and reduces the dangers of contaminated needles in the community environment.