NEED volunteer

Based in Berkeley, California, NEED is unique among needle exchange programs because we are a volunteer-based collective. We started in September 1990 by a group of HIV+ persons, people in recovery, and health activists as an underground program operating out of a baby carriage on the corner of Hearst and San Pablo Avenues in Berkeley.

Currently, we operate from a black van with our logo and title written on the side at three neighborhoods sites each week. We offer free, anonymous services in a client-centered manner, and we are dedicated to the prevention of infectious diseases and to improving the physical, spiritual, and political health of drug users. We also offer overdose prevention began an overdose prevention and education component to address the rising number of overdoses among injection drug users.


Every Thursday, a project of the Berkeley Free Clinic offers free HIV testing as well as Hepatitis test panels and Hepatitis A and B vaccinations. Our Sunday site offers free, anonymous Hepatitis testing and vaccination at the Berkeley Free Clinic. We provide information and referrals for medical, housing, social support and treatment programs.


In an average week, 49 people come to NEED to exchange 11,834 syringes. However, there still is a commonly reported fear by clients of being targeted by police while traveling to or from an exchange site. The result is that at least 60% of clients served by NEED are secondary exchangers, or individuals who come and exchange syringes for themselves and others who are unable to come to site. According to a NEED client input survey, made possible by the California Endowment (2004), our average participant exchanges syringes for 5 other persons, meaning NEED actually serves closer to 245 people in an average week. We have been able use secondary exchange as an effective way to reach out to communities which were previously inaccessible to harm reduction efforts. Aggregate utilization data show that NEED exchanges over 600,000 syringes annually!

HIV in Berkeley

With an incidence of 29.6 cases per 100,000 population for a three-year average, Berkeley has reported AIDS rates higher than either Alameda County (27.7/100,000) or California (22.1/100,000). While Berkeley has 7.7% of the total Alameda County population, it has 10% of the county's AIDS cases. Berkeley was second only to Oakland in the number of people reported with AIDS in the major cities of Alameda County. Injection drug users comprise over 25% of living AIDS cases and over 20% of new HIV infections in Berkeley.


We carry five different types of syringes, including syringes for individuals who inject steroids and hormones. In addition to carrying an assortment of harm reduction supplies, we also have tables of additional resources for clients, including safer-sex supplies. A fundamental part of NEED's mission is responding to the needs of our participants. NEED is still a volunteer-run collective, with deep and effective connections in the user, medical, public health research, and recovery communities. We constantly strive to respond to the actual needs of users, their friends, and families in the community, by improving and changing our services in response to client feedback.

NEED Now and Then — A Timeline