The analysis revealed that intravenous drug users in San Francisco are committed to working with the needle exchange program and with other intravenous drug users to help decrease the transmission of HIV. However, the political and social context in the United States may not as easily foster user organizations as in Europe and Australia. Results also indicated that issues of people's financial status may well impede organizing attempts, because people who experience scarcity in conjunction with severe stigmatization may focus their energies on survival rather than betterment. In addition, stigmatization may force people to individualize scarcity rather than view it socially and collectively. Findings suggested that in order to foster user organizations and broaden its harm-reduction approach, Prevention Point will have to confront internal and external contradictions to serve as a conduit for necessary social and political change. Notes and 29 references (Author abstract modified)