DEBRA J. SAUNDERS A Shot in the Dark

SAN FRANCISCO didn't have any reported cases of pediatric
AIDS in 1995 or 1996. Pat Christen, Executive Director of
the San Francisco AIDS Foundation credits two factors: the
city's aggressive drug treatment of pregnant women with HIV
and the local needle exchange program.

The oneforone dirtyforclean exchange program is
subsidized with city dollars, although a violation of state
and federal laws. It also may be the reason New York drug
injectors have twice the rate of HIV as in San Francisco.

On a recent Thursday, 1,615 needles were turned in at a
women's exchange in the Mission District. Women who traded
their needles, and those of their lovers and friends, also
received food vouchers and a bite to eat. Others saw
volunteer medical workers, who drain abscesses, distribute
vitamins, give flu shots and pregnancy tests, examine rashes
and refer women with hepatitis or pregnancies to
fullservice clinics.

Volunteer doctor Lisa Packus showed me medical kits they
give to heroin addicts who want to kick the habit in a hurry
which often means by themselves. Workers try to help
those who want to get off drugs. There aren't as many takers
as you'd like. But recently one woman kicked heroin with the
help of such a kit, Packus said.

The dirty clothes, pitted faces and spacedout look HIV
Prevention Project head Roslyn Allen said most of the
exchangers were under the influence of something ``to some
extent or another'' of many exchangers were dead
giveaways that they were users. Others didn't look like
junkies. Their skin was still clear, their clothes suggested
actual employment.

Maria lives in a bus with her boyfriend. Jerry lives on SSI
and Social Security. Both said they are not HIV positive.
Both believe that without the program, they'd be buying
needles on the street. Christen said it is wrong to assume
these women don't care about themselves because they're
junkies. They do care. They show up Thursdays from 5:30 to
7:30 for clean needles and other treatment.

It's true, when government subsidizes something, it will
increase. That principle holds with this program, except
that what increases isn't drug use federal studies have
confirmed but needle use. Free clean needles means
shooters don't reuse or share needles as often as they used
to.

I believe in tough love: no SSI for people because they're
substance abusers, arresting those who steal or camp on
sidewalks. But while authorities must push the hard tack for
the safety of the community, others can offer a hand to
these poor souls. Exchange workers reached out to these
women and tried to pull them from drug abuse, or failing
that, protect them from disease.

Toward the end of the exchange, a mom came with a girl who
looked to be 6 or 7. I've seen my share of substance abusing
moms and their kids. These two looked about as good as they
get. In Reeboks and with her backpack, the mother looked
like your everyday working class mom: a little tired. The
little girl seemed OK. She didn't have that vacant look you
see in neglected kids.

I could never volunteer for this program because I'd call
the cops pronto in order to spare that child from likely
neglect. Instead, a worker lovingly greeted the little girl
and whisked her to a children's area in the back, where she
was spared watching her mom stand in an endofthenight
line of other users, then pull 165 used syringes from her
backpack. (No doubt mom was exchanging needles for herself
and friends.)

After the mother was given new needles, a worker brought the
girl to her mother and they left. I watched them walk down
Valencia Street. The little girl was holding her mother's
hand and skipping.

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