In 1988 official reports in England and Wales and Sweden recommended the widespread adoption of syringe exchange schemes (SES) to reduce the risk of HIV infection amongst intravenous drug users (IVDUs). The British Government accepted the recommendation and by the end of 1989 120 SES had been established in England alone. The Swedish Government did not accept the recommendation and by the end of 1989 the only schemes operating with official recognition were those in the cities of Lund and Malmö, on which the official report in Sweden had originally been based. The paper argues that the factors explaining these contrasting outcomes involve a number of inter-relating professional, institutional, historical and cultural differences between the two countries which have made the care and treatment of misusers in the UK a depoliticized and technical matter for professionals, while in Sweden it is a highly politicized one, bound up with issues of national identity and character.
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