I don't think they're mutually exclusive. I think it's a bit of a false dichotomy. I think an institution.... One measure of institutional safety is also institutional health. If I'm at a high risk of contracting a blood-borne disease because of the extremely high rates of hepatitis C or HIV, then I'm at risk, and I may also be at risk of being stabbed with a needle or punctured.
I don't think they're mutually exclusive. In fact, from a public health standpoint, I don't think there is any question about the benefit of needle exchange. Syringe exchange has been around since the 1980s, and in Canada I think since 1985 or 1988. I think there's a pretty good understanding that syringe exchange programs are good public health policy. The difficulty is translating that policy into an institution.