In this context, professionals concerned with legitimizing NEPs may sometimes neglect aspects of everyday logistics and social organization and obscure important choices that have to be made to promote NEPs. In particular, formal institutions such as "storefront" or community-based NEPs and the model of syringe availability through pharmacies, vending machines, and user networks are viewed as complementary strategies that respond to diverse needs and target different populations rather than as an either/or choice. Advantages and disadvantages of each particular approach make it likely that maximum effectiveness will be achieved through a combination of every possible form of needle distribution, each tailored to specific and cultural circumstances. The NEP experience in New York City is examined, from the clandestine origin of NEPs in 1990 through their first years of official functioning between 1992 and 1996. 19 references