NEEDLE EXCHANGES DO WORK

As president of the organization that runs the District's only
needle-exchange program, I want to correct false assertions made by Calvina
Fay [letters, April 26].

Ms. Fay said, "Most needle exchange programs are not exchanges at all, but
are needle giveaways." However, exchange rates of dirty needles for clean
ones are extremely high, exceeding 90 percent in most cases. In the
District, we exchange more than 3,000 needles a week with a return rate of
97 percent. This ensures that dirty needles are not discarded in the streets.

Ms. Fay questioned whether needle-exchange programs are a successful HIV
prevention tool. Studies -- including those conducted by the U.S. Centers
for Disease Control and Prevention, the U.S. General Accounting Office, the
National Institutes of Health and the Office of Technology Assessment of

Congress -- unanimously concluded that needle exchanges do reduce HIV
transmission. None find that the programs increase drug use.

Ms. Fay misrepresented a Vancouver study as showing that needle exchange is
"a tremendous failure," despite the Canadian authors' numerous public
clarifications including an April 9, 1998, op-ed in the New York Times.

Most recently, study co-author and University of British Columbia
epidemiologist Martin Schecter explained that individuals who participate
in Canadian needle-exchange programs are expected to have a higher rate of
HIV infection because in Canada, unlike in the United States, it is legal
to purchase syringes in pharmacies without a prescription. Those who can
afford to buy syringes do not have to share needles. Those who participate
in needle exchanges, though, cannot afford to buy clean syringes and are
forced to share, significantly increasing their risk of HIV infection.

Among those who endorse needle-exchange programs are the American Medical
Association, American Nurses Association, American Academy of Pediatrics
and the American Public Health Association. These respected associations
agree that needle-exchange programs slow the spread of HIV without
encouraging illegal drug use.

PATRICIA S. FLEMING
President
Prevention Works
Washington