Needle exchanges, long credited with helping to slow the spread of infectious diseases by public health experts, have made inroads in recent years, even in states traditionally opposed to them.

A ban in federal funding for needle exchanges was lifted earlier this year. States including Ohio, Kentucky, and West Virginia have made it easier, or in some cases possible for the first time, for programs to operate. Even Vice President-elect Mike Pence, who resisted needle exchanges on moral grounds, repealed a ban on syringe exchanges as governor of Indiana when confronted with an HIV outbreak (albeit too slowly for many experts).

New data released by federal health officials Tuesday further demonstrated the value of needle exchanges, suggesting they had contributed to a major reduction in new HIV infections among people who inject drugs.

But the report also included some warnings. There aren’t enough needle exchanges or clean needles being supplied, and few drug users use only sterile syringes, researchers from the Centers for Disease Control and Prevention found. Plus, changes in the demography and geography of drug users suggest problems to come.

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