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Aims. To examine the association between recipient-sharing of needles and syringes and demographic characteristics, injecting behaviour and needle and syringe exchange utilisation . Design. Self-report data from serial cross-sectional surveys. Setting. Multiple street, needle and syringe exchange and drug treatment sites throughout Glasgow. Participants. 2576 current injecting drug users (IDUs) recruited during 1990–94. Findings. In the multiple logistic regression analysis, a significantly lower level of recipientsharing was associated with respondents who resided within 1 mile of a needle and syringe exchange compared to those who lived further away (adjusted OR 1.3; 95% CI 1.0–1.6), and by IDUs who reported obtaining either 6–15, 16–30, or > 30 sterile needles and syringes in an average week from a needle exchange and/or pharmacist (adjusted ORs 0.55, 0.34, 0.25; 95% CIs 0.3–0.9, 0.2–0.6 and 0.2–0.4, respectively) compared to those who obtained no sterile equipment from these sources. Recipient-sharing of needles and syringes in the previous 6 months reduced significantly between 1990 (43%) and 1991–94 (27–33%) (p < 0.0001); this decline was not explained by needle and syringe exchange utilization, suggesting that additional factors were influencing behavioural change at that time. Conclusion. Our data indicate that improving injectors’ convenience of access to exchange facilities and increasing the numbers of sterile needles and syringes available to them is likely to result in further reductions in recipient-sharing, and thus the potential for blood-borne virus transmission, among IDUs.