NEEDLE EXCHANGE OK LIKELY

San Mateo County Could Take First Steps

San Mateo could become the latest Bay Area county to support needle-exchange
programs if the Board of Supervisors declares hepatitis C and HIV public
health emergencies today.

The proposal, which comes on the heels of a state law that decriminalizes
needle exchange programs, would help reduce and prevent the spread of both
blood-borne diseases among intravenous drug abusers, county officials said
yesterday.

Alameda, Marin and Contra Costa counties, as well as the cities of Oakland,
San Francisco and Berkeley have declared hepatitis C and HIV public health
emergencies. Santa Clara County has declared HIV a public health emergency
and soon may add hepatitis C to the list, according to the county's health
officer.

``Once you acknowledge something exists, I feel responsible for doing
something about it,'' said Supervisor Rose Jacobs Gibson, who requested the
emergency declaration. ``It's our way of being sure that we try to do as
much as we can to resolve this as best we can.''

Earlier this month, the board authorized $200,000 for health officials to
test people at high risk for contracting hepatitis C after a county health
study determined that cases of infection were on the rise, particularly
among minorities and young people.

About 13,000 county residents are infected with the disease, which enters
the body through direct blood exposure. Nearly 2,000 people are infected
with HIV, the virus that causes AIDS, said Dr. Scott Morrow, the county's
health officer. The county health department believes that between 17 and 23
percent of HIV infections are transmitted through injection drug use, he
said.

``We don't have those figures for hepatitis C,'' Morrow said. ``But we do
know from national studies that about 60 percent of new infections are
caused by injection drug use. The rest are through sexual transmission and
other routes.''

For Joey Tranchina, a community AIDS activist and needle-exchange advocate,
the county's declaration would be long overdue.

Tranchina, executive director of the AIDS Prevention Action Network, started
passing out needles ``underground'' in 1989. Two years later, he and another
AIDS activist, Camille Anacabe, gained widespread media attention after they
were arrested for swapping needles outside a Redwood City methadone clinic.

The case went to trial, but ended in a mistrial when the jury deadlocked 11
to 1 for acquittal. The San Mateo County district attorney's office decided
against a retrial, and Tranchina has delivered fresh supplies to intravenous
drug abusers since then.

``It's certainly about time,'' said Tranchina, who has financed his program
through donations from United Way and the Peninsula Community Foundation.
``I think that it's going to be an interesting new phase, and I hope it will
lead to us being able to do a lot more.''

As a longtime hepatitis C survivor, Luther Brock said the county's
acknowledgment of the problem is a step in the right direction. Brock, a
member of the San Mateo County Hepatitis C Task Force and an outreach worker
for the nonprofit AIDS Community Research Consortium, is a former
intravenous drug abuser.

``I would like to see it, specifically because the rate of infection for
hepatitis C is at least four times greater than the rate of infection for
HIV,'' said Brock, who has lived with the disease for 27 years. ``It won't
make more addicts, but it will reduce the harm to other people. A lot of
substance abusers don't think that it will happen to anyone but them.''