A PROVEN STRATEGY TO FIGHT HIV

FOR ALL the success medicine has achieved in treating HIV/AIDS, the
United States still isn't doing enough to prevent new infections in
the first place. Public health officials have to work with one hand
tied behind their backs because Congress has banned the use of
federal funds for needle exchange programs. Last week, the NAACP, the
Urban League, and other organizations called for Congress to repeal
the ban. They are right to do so.

The use of contaminated drug needles is blamed for about one-third of
the 40,000 new HIV cases in the United States each year. This method
of transmission is especially common among African-Americans, who
make up just 13 percent of the US population but accounted for about
half of all new HIV cases in 2005.

There are already about 200 needle-exchange programs in the United
States, but many more are needed. John Auerbach, commissioner of the
Massachusetts Department of Public Health, said that in studies of
HIV prevention methods, none has yielded results as positive as
needle exchanges. "We know it works," he said. Typically, drug users
involved in needle exchanges are also encouraged to get into detox programs.

Repeal of the ban on federal funding would be beneficial in two ways.
It would provide money for prevention efforts in communities that get
little if any support from their states. And it would go a long way
toward reducing community opposition to needle exchanges. Much of
that opposition is based on the mistaken belief that making clean
needles available to drug users encourages more use of narcotics. But
Auerbach said there is "no evidence of any documented increase in
drug use because of needle exchanges."

In Massachusetts, there are state-supported needle exchange programs
in Boston, Cambridge, Northampton, and Provincetown. Massachusetts
cities without needle exchanges, such as New Bedford and Lowell, have
historically had much higher rates of HIV cases transmitted by
needles than cities like Boston that have such programs.

In 2006, the state repealed the law requiring a doctor's presciption
to purchase hypodermic syringes, making it easier for drug users to
have access to clean ones. The state would help more communities
establish exchange programs, but a state law prohibits DPH from
setting up programs in communities that do not want them. The
Legislature should amend that law to permit the establishment of
programs after DPH consults with local officials, but not necessarily
require their approval. AIDS is a public health emergency. On both
Beacon Hill and Capitol Hill, lawmakers should ensure that public
health officials can fully use this effective means of limiting HIV
transmission.