COUNTY OFFICIALS SHOULD APPROVE NEEDLE EXCHANGES

Needle exchanges for intravenous drug users, most notably
administered by Prevention Point Pittsburgh, have operated in
Allegheny County for many years, but outside the law. Because it is
illegal, any effort made to prevent the spread of AIDS through dirty
needles carries with it the risk (though seldom realized) of arrest.

That may finally change sometime later this year if the county Board
of Health decides to declare a state of emergency and implement an
official, legal needle exchange program. Philadelphia took such a
step years ago.

While the numbers are still low, the local board was alarmed by a
doubling in the incidence (from 9 to 18) and rate (from 0.7 percent
to 1.5 percent) of HIV infection among intravenous drug users.

As difficult as it is to accept the notion of enabling illegal and
self-destructive behavior, the evidence is convincing and growing
that needle distribution reduces the rate of HIV infection without
increasing drug use.

Many reasonable and decent people appalled by the thought of giving a
needle to an addict, argue that it would be much better to focus
energies instead on drug treatment.

But the data suggest that the two can go hand in hand. Through needle
exchanges, health departments can also provide information about
treatment, screening services and health care. The clean needle is a
way to keep the patient alive until the treatment has a chance to
work.

The choice is not between shooting up with a clean needle and kicking
the habit. It is between shooting up with a clean needle or one that
is infected. Any public health agency true to its name would have to
provide the clean needle.

The state Health Department is not in favor of such programs, unable
apparently to get past the negative image to the reality of the
positive effect needle exchanges have in stemming the growth of HIV
infection. That's too bad.

Luckily, the county does not have to get permission from the state to
protect the health and well-being of its citizenry. The county Board
of Health has already moved beyond the state in requiring that all
diagnosis of HIV infection be reported to the Health Department.

In the coming months and years, the state will have a real idea of
just what is happening and how to react. The fact that the county was
willing to take the lead on this is a very good sign.

Knowing the numbers is important, but it is secondary to bringing
them down. Clean needle exchanges, complete with Health Department
services, is a proven way to accomplish that.