HIV THREAT

Stan Stanfield (Letters, December 20) is concerned about needle and syringe
programs being an incentive to inject drugs. This is a common concern and
seems logical (giving out free needles seems likely to lead people to
inject drugs). However, repeated research has found no evidence of such
programs leading to an increase in drug use or injecting.

We must also remember that these programs have literally saved hundreds of
thousands of lives. HIV can spread quickly among injecting drug users, with
50 per cent or more of users becoming HIV-positive within one to two years
in many cities and regions around the world.

If Australia has 200,000 injecting drug users, this means that 100,000
could have become HIV-positive by now if our prevention programs had failed
over the past 20 years.

Apart from the human tragedy this represents, the cost of combination HIV
drugs (about $15,000 a person a year) means the annual and increasing bill
for HIV medications could by now have reached $1.5 billion more than is now
being spent on AIDS care. The problem with prevention is that, when we are
successful, we forget why the prevention was thought to be necessary in the
first place.

Australia remains at risk of a HIV epidemic among drug users, we already
have a hepatitis C epidemic, and there is an unacceptably high rate of
overdose.

A mix of programs and strategies is needed to address this set of issues.
Needle and syringe programs need to remain a major part of that mix while
new elements (such as injecting rooms) are trialled to see whether they
should be added to the mix.

Dave Burrows,
Marrickville.