been enough local political people with backbone that have supported us and so has the health department, and so we've weathered attacks. And politics is still a number one problem. AIDS is all politics; it's not science and stuff like that (D. Purchase, oral communication, June 2002). In other areas, local direct action has been less successful. In 1999, New Jersey reported more than 19000 cumulative IDU-related AIDS cases, and 2.3% of the residents of the Jersey City metropolitan statistical area (MSA) were injecting drugs. However, the governor and city officials opposed distributing sterile syringes to injection drug users, and local police arrested clients and volunteers in an attempt to suppress the state's only publicly visible SEP. In the United States, development and maintenance of services for injection drug users, specifically SEPs, are linked to specific activist groups and social movements such as the AIDS Coalition to Unleash Power (ACT UP) and the harm reduction movement. In the late 1980s, concerned activists, usually former or current drug users or members of ACT UP, began setting up SEPs in some localities. In the past, ACT UP had successfully used "direct action" (i.e., political activism strategies such as demonstrations and workplace occupations) to contest the stigmatization of people with AIDS by highlighting the underlying stigmatization rooted in homophobia. Many of the same activists adopted a similar philosophy and tactics in creating and demanding AIDS prevention services for injection drug users by distributing clean needles to users regardless of legality. 34 Members of