EXCHANGES TRYING TO REDUCE HARM

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