SUBWAY ADVERTISEMENT FOR NEEDLE-EXCHANGE PROGRAM PROVOKES DEBATE

NEW YORK -- The elegant hands, not quite touching, are recognizable to any
art lover familiar with Michelangelo's fresco adorning the ceiling of the
Sistine Chapel, which shows God reaching forth to infuse Adam with life.

But in a new subway advertisement, the divine hand extends five hypodermic
syringes for injecting heroin or cocaine.

Through this month, 1,140 of the advertisements will appear in New York
City's subway cars to promote needle-exchange services available in the
city. The advertisement includes a telephone number, (800) 361-9477, for
drug users to learn where to swap their used needles for new ones and be
tested for HIV, the virus that causes AIDS.

"Sharing needles is the number one cause of HIV in New York City," the ad
says. "If you shoot drugs -- please do not share needles."

The advertisement's sponsor, Positive Health Project, an HIV-prevention and
needle-exchange center on Manhattan's West Side, said the ad campaign was
the first on public transit in the nation to promote needle-exchange
programs as an effective way to curb the spread of AIDS.

It's a message that has already drawn objections.

"It's not even a disguised attempt to legalize drugs," Dr. James L. Curtis,
director of psychiatry at Harlem Hospital Center and a critic of needle
exchanges, said of the advertisement. "It's a frank and forthright attempt
to bless the concept."

Jason Farrell, the executive director of Positive Health Project, said
education on needle exchanges was necessary in light of statistics showing
that New York City has an estimated 250,000 intravenous drug users, as many
as half of whom have contracted HIV by injecting drugs with tainted needles
or having sex with others who do. This exceeds the national average cited
by Dr. David Satcher, the surgeon general, who attributed 40 percent of new
AIDS infections in the country to contaminated needles.

"It's time," Farrell said, "that the general public understands that the
needle-exchange programs are the most effective public health initiatives
in the city today in preventing infectious diseases."

Up to 5,000 new HIV infections are diagnosed in New York City every year,
he said, and three-fourths of injecting drug users do not take advantage of
needle-exchange programs.

Farrell said the advertisement was chosen by a "focus group" of drug users
who were asked which of two posters was more likely to entice them into a
needle-exchange program.

The New York City Transit Authority is charging nearly $14,000, its minimum
rate for nonprofit groups, to carry the advertisements in about 20 percent
of its subway cars for a month, Farrell said.

The money was provided primarily by the Drug Policy Foundation, an advocacy
group for more liberal drug policies that is itself partly financed by
George Soros, the philanthropist. Last year, he donated $1 million for
needle exchanges.

Needle exchange continues to be a contentious issue. In April, President
Clinton refused to provide federal money for needle exchanges, despite a
finding by Secretary for Health and Human Services Donna Shalala that they
reduced the incidence of HIV without increasing drug use.

Needle exchanges have existed in New York City since 1992, when the state
waived the law prohibiting possession of syringes without a prescription.
New York state helps subsidize nine programs operating in Manhattan, the
Bronx and Brooklyn.

"We need to find ways of expanding and supporting syringe-exchange programs
much more than we have," said Denise Paone, research director of the
Chemical Dependency Institute at Beth Israel Medical Center, and a
supporter of the new advertisements.

Taking the opposite view was Dr. Mitchell Rosenthal, the president of
Phoenix House, a substance-abuse treatment and prevention network based in
New York. Last month, Phoenix House ran subway advertisements carrying the
message: "Don't throw your life away. Thousands of people like you have
recovered from substance abuse." It gave a phone number, (800) HELP-111,
for addicts to find treatment programs.

Rosenthal said of the new needle-exchange advertisements: "We are offering
health, fulfillment and freedom from drugs. They're pushing the
continuation of addiction and despair."

Copyright 1998 The New York Times Company


Checked-by: (Joel W. Johnson)