NEEDLE EXCHANGE PREVENTS HIV
Dawn Day and Kendra Wright

Dawn Day, Ph.D. is the director of the Dogwood Center in Princeton, New
Jersey. Dr. Day is a sociologist and activist scholar who writes on issues
of social justice and AIDS. Kendra Wright of Falls Church, Virginia, is the
manager of the Families, Women and Children project of Common Sense for
Drug Policy.

Today we are joining with several thousand other women and men who have
traveled to Washington, DC, from across the nation to carry an important
message to Congress and the Clinton Administration. Heed the scientific
findings, we will urge. Follow the advice of our public health experts, we
will plead. Fund clean needle programs and slow the spread of HIV/AIDS, we
will cry.

The spread of drugrelated HIV is a terrible problem, affecting thousands
already, and with the potential of affecting thousands more. In New Jersey
alone, more than 19,100 have injectionrelated AIDS or have already died
from it. A Centers for Disease Control researcher, Dr. Scott Holmberg,
estimates that an additional 46,200 people in New Jersey are uninfected but
at risk because they inject drugs.

Nationally, 190,000 Americans are now living with injectionrelated AIDS or
have already died from it. Across the US, an estimated 1.3 million are
uninfected but at risk because they are injecting drugs.

Some 11,000 preventable HIV infections will occur by the year 2000 if clean
needle programs are not implemented nationally, according to an article
published recently in Lancet, a respected medical journal.

Infection with HIV/AIDS is not the inevitable death sentence it once was.
Among those who can afford the new combination treatments, about a third
are helped. So happily there are fewer AIDS deaths now than in the past.
But even so, many are still dying and those living with the combination
drugs often suffer painful and sometimes incapacitating side effects.

For those uninfected and still engaged in injecting drugs, prevention is
very important. Prevention is also important for the drug user's wife or
husband and newborn children and for the rest of us. We are a society
that, medically speaking, shows a concern for all its members. When
someone arrives at the emergency room door suffering from a drug overdose,
we immediately provide lifesaving medical treatment. We do not withhold
medical treatment saying "Drug use is wrong; giving you medical care will
send the wrong message."

Our society has many ways of sending the message that injecting drugs is a
very bad idea, everything from media educational campaigns to prison
sentences. But when it comes to a health issue slowing the spread of a
deadly, infectious disease our society must begin to follow the advice
of its independent medical experts. The American Medical Association and
the American Public Health Association and their New Jersey counterparts
have all taken positions that clean needle programs are necessary to reduce
the number of HIV infections caused by dirty needles.

Six federallysponsored studies and the National Institutes of Health
Consensus Panel have found that clean needle programs curb the spread of
HIV and do not increase drug use. Through the caring personal contact that
occurs at clean needle program sites, persons who use drugs are sometimes
moved to reduce their drug use or enter drug treatment programs. It turns
out that clean needle programs are not only a very successful antiAIDS
strategy but also a modestly effective antidrug strategy.

Clean needle programs are profamily and prochild. Think of the terror
and anguish of the child watching a parent die of AIDS. Consider the
terrible loss to family and friends as a young adult, having recovered from
an interval of injecting drugs, dies of AIDS just as he begins to blossom
and develop his talents. Think of the heartbreaking loss to grandparents,
of the grandchildren who will never be born. We cannot continue to pursue
policies that permit such tragedies to occur.

The American public agrees. A 1996 nationwide survey commissioned by the
Kaiser Family Foundation found that twothirds of Americans support clean
needle programs as a way of slowing the spread of HIV among persons who
inject drugs.

Outdated state laws, like those in New Jersey, that punish clean syringe
possession must be changed. Antiquated state laws, like New Jersey's, that
prohibit the sale of syringes through pharmacies. must also be eliminated.
But today our political attention is focused on the national level. It
will be easier to change New Jersey's deathcausing laws when federal funds
become available. And at least in some states, such as New York and
Pennsylvania, the funds could at begin their lifesaving work at once.

The Clinton Administration has the power to make funds available for clean
needle programs now. It should do so at once. Those in the House who
recently voted to ignore the scientific evidence on the effectiveness of
clean needle programs and prohibit the use of federal funds for clean
needle programs should immediately reconsider for both humanitarian and
fiscal reasons.

Clean needle programs that prevent the spread of HIV cost less than $2000
per user per year. The combination drugs needed to treat an HIV infected
person cost anywhere from $10,000 to $15,000 a year. From a human point of
view, we cannot let the pain, suffering and death of the AIDS epidemic
spread. From a fiscal point of view, we cannot afford to.

For people who inject drugs, the group that now makes up half of all new
HIV infections, education alone is not enough. Condoms are not enough.

Study after study has shown the effectiveness of clean needle programs. It
is vital that we use our HIV prevention dollars wisely. Clean needle
programs must become a part of our federal campaign to control the AIDS
epidemic. It is a matter of life and death.