NEEDLE EXCHANGE PROGRAMS PROLIFERATE

17.5 million syringes distributed last year despite funds ban

Despite a congressional ban on federal funds for needle exchanges to
prevent the spread of AIDS, the programs are broadening their activities
and spreading swiftly across more than 30 states, the government's Centers
for Disease Control and Prevention reported yesterday.

Financed by ingenious combinations of local government funds and private
donations, the programs distributed more than 17.5 million syringes to
injection drug users last year alone -- whether the operations were legal
under state or local laws or were operated entirely underground, the agency
said.

Because federal health chief Donna Shalala has refused to lift the ban on
funding imposed by Congress 10 years ago, the CDC report was circumspect
and did not explicitly declare that needle exchanges have proved successful
in the battle against HIV disease. But it did point to other recently
published research reports that say exactly that.

Wherever they operate, according to the reports cited by the agency, needle
exchange programs have notably slowed the spread of HIV infections.

The programs provide instruction in the use of condoms and other safer-sex
measures, refer thousands of injection drug users to drug abuse treatment
programs and often offer on-site health care to addicts.

The needle exchange program operated by the San Francisco AIDS Foundation
was by far the most active one in the country, distributing 1.2 million
syringes last year alone, the CDC reported.

But even that figure is an underestimate and out of date, according to Pat
Christen, the foundation's executive director.

By now, she said yesterday, the San Francisco program is exchanging clean
syringes for contaminated ones at the rate of 2.4 million a year, with the
strong support of Dr. Mitchell Katz, the city's public health director.

``Needle exchange programs are quite effective in slowing the spread of
HIV,'' Christen said, ``even though the administration persists in its
absurd position that prevents federal financing for them.''

The CDC figures, published in the current issue of its Morbidity and
Mortality Weekly Report, indicate that 113 syringe exchange programs were
active in the United States last year and 100 were reporting to the CDC in
detail. Two years ago, there were 84, and two years before that, 55.

The federal agency's report noted that the needle exchange programs are
successfully reaching people who are at risk for many blood-borne
infections, including HIV, the virus that causes AIDS, and hepatitis C,
which currently afflicts some 4 million Americans and can lead to fatal
liver disease.

The programs also increase the number of drug abusers who use a syringe
only once, thereby eliminating the re-use of potentially contaminated
syringes, the agency said.

Drug users who obtain their needles from the programs have lower rates of
HIV infection than those who obtain needles on the black market or who
share them with other users, according to the CDC analysis.

1998 San Francisco Chronicle

Checked-by: Mike Gogulski