IN REPLY to Julianne Whyte's two letters in The Border Mail (May 26
and May 31) criticising the effectiveness of the needle and syringe
exchange programs reducing the incidents of blood borne viruses, we
would like to clarify the misinterpretations of the rationale for
operating exchange programs in the community.

The philosophy of harm minimisation forms the basis of Australia's
education and prevention program with regards to HIV and other blood
borne viruses.

Harm minimisation seeks to balance the cost to the whole community and
to individuals engaging in high risk behaviours.

This approach acknowledges the fact that some individuals will
continue to participate in high risk behaviours, while others will
modify their behaviours with appropriate advice and
interventions.

Exchange programs are not and have never been a service set up to
protect injecting drug users from the ramifications of illicit drug
use.

Rather, it is a public health strategy, one devised to reduce harm in
a broad sense to all Australians.

In regard to Julianne Whyte's suggestion that exchange programs are
not reducing the incidence of hepatitis C transmission in injecting
drug users, the statistics for hepatitis C might be misleading.

Many people recently diagnosed do not know when they were originally
infected with the hepatitis C virus, the infection might have occurred
many years ago.

However, due to the increase in public awareness of hepatitis C,
people who consider themselves to have been at risk are only in the
past few years being tested.

The reality is that they could have been positive for a number of
years without realising that they have been infected.

There is significant anecdotal evidence to support this
fact.

The National Centre in HIV Epidemiology and Clinical Research (1999)
suggests the incidence of injecting drug users sharing equipment has
decreased to nearly half over the past four years.

These figures are encouraging in that they demonstrate the
education-information component is proving to be effective.

The majority of injecting drug users that access our program state
they they dispose of used equipment in the appropriate manner.

It seems that inappropriate disposal is unfortunately occurring in a
minority of injecting drug users.

We continue to provide information and resources to injecting drug
users to encourage and promote responsible and safer practices.

ALCOHOL AND OTHER DRUGS UNIT,
Upper Hume Community Health Service, Wodonga