Official challenges notion needle program spreads AIDS: Vancouver
addicts already know each other, so new social links not a factor, she
says.

By: Marina Jimenez

Most addicts who use Vancouver's needleexchange program already know
one another, says the manager of the program, rebutting claims the
program fosters new social connections that can lead to the spread of
HIV.

A study of 1,006 injection drug users in the Lower Mainland found
there is a higher rate of HIV infection among those who use the
program than among those who don't. Some doctors hypothesize that's
because the program allows addicts to congregate in one place where
they may develop friendships and share needles, causing an increase in
the transmission of the virus.

But Judy McGuire, who manages the Downtown Eastside Youth Activities
Society's needleexchange program, says most addicts are not
strangers.

``By the time they come here, they already know each other.''

McGuire believes Vancouver's HIV epidemic is caused by other factors,
such as inadequate housing and the growing popularity of cocaine,
which is injected more frequently than heroin.

``When addicts get enough cocaine into their system, it affects their
judgment ... the need for the drug becomes so compelling that clean
needles cease to be a priority,'' said McGuire. ``The high
preponderance of singleroom hotels that are poorly maintained also
support the drug culture.''

And she said the plethora of 24hour grocery stores in the downtown
east side has led to increased drug use as the food stores become
fronts for drug dealers.

Dr. Patricia Daly, the communicable disease consultant with the
Vancouver and Richmond board of health, agrees these are all
contributing factors. But she said the study shows Vancouver's
needleexchange program isn't enough to stop the HIV epidemic. The
city has the highest rate of HIV infection among injection drug users
in North America.

``We are not saying don't have a program. But you have to look at how
the needles are distributed ... and look at managing the program in a
different way,'' said Daly.

The study found that 23 per cent of 1,006 injection drug users in the
Lower Mainland are HIV positive. Of this group, 81 per cent had used
the needle exchange program more than once a week. Of those who tested
HIV negative, 71 per cent had used the needle exchange program more
than once a week.

Dr. Michael Rekart, who coauthored the study, said it's unclear the
needle exchange program actually causes the higher infection rates.

``It's possible that when you have one needle exchange you may create
new social networks that end up dealing drugs or injecting new
partners,'' said Rekart, who is the director of the province's
STD/AIDS program. ``But it's also possible that the needleexchange
program attracts people who already have the high risk behavior, who
inject more, share more needles and have poor social support.''

He said the study does conclude that needleexchange programs aren't
enough to stop the spread of HIV. Other support services such as
counselling and addiction programs are also needed.

Decentralizing the current program may also help. McGuire says the
Downtown Eastside Youth Activities Society wants to open a second
needleexchange program in the Granville area.

Already, street workers in mobile vans go out every night and
distribute between 3,000 and 4,000 needles all over the city. They are
constantly changing their routes, visiting new drug haunts as soon as
they become known.

``We are following the behavior instead of leading it,'' said McGuire.

American studies by the Centre for Disease Control have long shown
that needleexchange programs help reduce the spread of infection.

The centre has also ranked Vancouver's program which began in 1988
as one of the top three programs in North America

About 3,000 people visit the program's downtown site every month and
last year 2.38 million needles were distributed.