In the 1990s, many more syringe exchange programs are established by governments, community activist-led groups, and private foundations. This is linked to the rise of HIV/AIDS cases among people who inject drugs, which brings a sense of public urgency to the issue.
The North American Syringe Exchange Network (NASEN) grows rapidly from approximately 50 programs in 1995 to over 100 programs by 1997. There are only 32 articles on syringe exchanges in the U.S. published prior to 1995; by 1996 there are 63, and 150 by 2000.