LESSON FOR AIDS FIGHTERS - SYRINGE SWAPS WORK

A decade ago, New Yorkers agonized over whether to provide clean
needles to the city's 200,000 people who inject drugs. Officials
worried that syringe exchanges might inadvertently make drug abuse and
AIDS even more widespread.

Well, surprise. Their qualms have proved to be not just a little
misguided, but dramatically off base - a fact that policymakers from
Queens to Washington ought to ponder.

In a paper delivered this week to a national HIV prevention conference
in Atlanta, Don DesJarlais of New York's Beth Israel Medical Center
reported that the proportion of infected drug injectors in the city
has tumbled by more than half since the 1980s. Or to put it another
way: In 1990, before the state allowed needle-exchange programs,
about 50 percent of the city's drug injectors were infected with HIV.
By 2000, that ratio had fallen to 20 percent. Meanwhile, the annual
infection rate among intravenous drug injectors plummeted from 4
percent a year in 1990 to 1 percent in 2000.

New York offers a powerful model for other cities now wrestling with a
needle-based HIV problem. And yet, the city can't get too caught up in
self-congratulation. For one thing - thanks in part to NIMBY
opposition - Queens lacks a single syringe-exchange effort. With some
effort, the city could bring its rates lower.

A law that took effect in January does allow pharmacies to sell
syringes to drug users, and some Queens outlets are participating in
the program. That's fine, but it isn't enough.

A genuine syringe-exchange program also offers counseling and can
point drug abusers to an array of ancillary health care services.

Washington's problem? It is courage. Study after study has shown that the
feds should pay for syringe exchanges. But the Clinton White House
frantically danced around the idea, and Congress steadily refused to ante
up. Maybe the New York study will change some minds.