NEEDLES WITHOUT STRINGS

ATLANTIC CITY -- THE mobile health van is parked outside the old
stone church on Pennsylvania Avenue. It's a prime location for
reaching this town's large population of drug users: The church
houses a busy soup kitchen; there's a probation office across the
street; adjacent Pacific Avenue has an active sex trade.

A man with a goatee comes tapping at the window. "Do you have free condoms?"

"Will you come in and be tested?" counters Scherri Rucker-Graves, the
nurse administering HIV tests.

He agrees, and swabs his gums with a tester. Then, during the 20
minutes it takes for a red line to show up (positive) or not
(negative), Ms. Rucker-Graves launches into her counseling session.

Her first question: "Do you have a risk factor?"

"Atlantic City is a risk factor," the man replies.

True enough. A block from the turrets of the Taj Mahal, the city's
Health Department is working to stem an epidemic that has receded
somewhat from public consciousness, but still strikes another 2,000
to 3,000 New Jerseyans each year.

This state has one of the nation's highest AIDS caseloads. In this
town, a ghetto with glitz, one in 40 residents is H.I.V.-positive or
has AIDS; most are intravenous drug users and their sexual partners.

Early in the epidemic, scientists recognized that the needles that
heroin and cocaine users share were transmitting the virus. They also
learned that collecting the dirty needles and providing sterile ones
could slow the spread of the disease. When New York City's
needle-exchange program expanded in 1992, new infections among drug
users dropped by three-quarters.

"It's clear that syringe exchange works," says Dr. Don Des Jarlais,
who runs the chemical dependency facility at Beth Israel in New York
and did some of the earliest research. And, "there's no evidence at
all of any detectable increase in drug use -- it's been looked at
every possible way."

By now, so many studies show the same results -- New York, New Haven,
San Francisco, Chicago and around the world -- that nearly every
state either permits needle exchanges, or allows pharmacies to sell
syringes without prescriptions, or both.

In only two are posturing politicians still condemning their citizens
to an incurable disease. The other is Delaware.

Last summer, when it looked as though three cities would finally be
able to run pilot programs -- under an executive order by the
departing governor, Jim McGreevey -- Atlantic City geared up. The
Health Department trained its staff and bought supplies.

"I've got boxes of syringes here now," says the city's health
officer, Ronald Cash.

He never got to distribute them; four legislators filed suit
challenging the order.

It's getting to be an old story.

Ignoring the overwhelming evidence, politicians demur that syringe
exchange programs "send the wrong message to our children" -- that
was Gov. Christie Whitman, refusing support in 1998.

Or they cry, "People want to keep us junkies" -- that was State
Senator Ron Rice two weeks ago, when I called to ask about his obstruction.

In the 10 long years since legislation was first introduced, it has
been bottled up in committees. Approved by local ordinances, then
thwarted by a county prosecutor. Passed by the Assembly but blocked
in the Senate. Permitted by order of the governor, then once more
stopped before it could start.

In that decade of dithering, another 20,000 people in New Jersey have
been diagnosed with H.I.V. and AIDS; the cumulative toll now exceeds 65,000.

In the van on Pennsylvania Avenue, Gene Brunner, the local H.I.V.
coordinator, sighs and says: "It makes us angry, because we still see
people getting AIDS through shared needles, and we know it can be prevented."

And the reason seems all too apparent.

If H.I.V. were threatening the well heeled and well organized, people
who demonstrate at the State House and make campaign contributions,
there would be needle exchanges wherever needed. But most victims are
poor African-Americans and Latinos, and drug addicts lack a political
action committee.

This legislative session, supporters are allowing themselves a little
hope: the new governor, Assembly majority leader and Senate president
are all on record in favor of needle exchange.

Maybe this is the year. "That's what we thought the last time, too,"
Mr. Cash says.

He would be happy to get those syringes out of his office in City
Hall, into the van where they could do some good. But he's a scarred
veteran of a long, ugly fight.