NEEDLE EXCHANGES SAVE LIVES

A July 23 letter from the medical adviser of the Children's AIDS Fund about
needle-exchange programs likely caused confusion, as some readers may have
assumed that its author was affiliated with the National AIDS Fund. Not
only is the National AIDS Fund not affiliated with the Children's AIDS Fund
but the National AIDS Fund supports needle exchanges as a sound public
health strategy for preventing HIV infection.

The author's conclusion that needle-exchange programs are ineffective is
based on incorrect information. Most research provides strong evidence of
the efficacy of syringe-exchange programs in preventing the transmission of
HIV, sexually transmitted diseases and other blood-borne diseases among
injection drug users -- without adverse impact on communities, such as
increased drug use. It makes little sense to concentrate on the four
studies the writer cited, because the design of these studies and the
behavioral characteristics of the study populations limit generalizing
these findings to U.S. populations.

In addition to their effectiveness in reducing HIV infections,
needle-exchange programs create an access point into social services, drug
addiction treatment and medical care for participants. In fact, needle
exchange -- as one component of a broad-based HIV prevention strategy among
the injected-drug population -- is supported by many medical organizations,
including the American Medical Association and the American Public Health
Association.

Further, because injection drug-related HIV transmission disproportionately
affects women, children also are disproportionately affected. More than
half of all children with AIDS contracted the disease indirectly through
injection-drug use. It is troubling that the author -- a representative of
a pediatric AIDS organization -- should ignore this fact.

MARY WILSON-BYROM
Interim President & CEO
National AIDS Fund
Washington