The Damage Done

AIDS ACTIVISTS PUSH FOR LEGAL NEEDLE-EXCHANGE PROGRAMS IN NC

Of the 184 US needle-exchange programs - a means of helping drug
users reduce the risk of contracting and spreading deadly diseases -
only two are in North Carolina, and neither are in Mecklenburg
County, the state's largest metropolitan area.

"It's desperately needed," said Eloise Hicks, executive director of
the Regional HIV/AIDS Consortium.

It's also entirely illegal. But that didn't stop Thelma Wright from
starting a program in High Point. Stung by the havoc wreaked by HIV
in her community, Wright began giving out clean syringes to drug
users in 1999. She'd search areas around bridges, ravines and empty
houses, where addicts, mostly street people or "soon-to-be street
people," would shoot heroin. She'd crawl through windows and lift up
mattresses to collect dirty needles. At first, users greeted Wright
with skepticism. "But once they learn who you are, they're your
friend," she said.

Wright is now co-chair of the Campaign to End AIDS, a national
coalition of grassroots activists, and she wants to stir interest in
needle-exchange programs throughout the state, particularly in
Mecklenburg County.

A report to county commissioners in January 2004 found that a
needle-exchange program could reduce transmission of disease in
Charlotte. It got nowhere, of course, though some commissioners have
voiced support. "Certainly, you want to discourage bad behavior, but
you also need to be realistic," said County Commissioner Jennifer
Roberts, who wasn't on the board then. "We need to look at it from
the standpoint of saving lives."

Guilford and Buncombe counties have passed resolutions supporting
exchanges. And a regional HIV/AIDS planning group, organized by the
state at the behest of the Centers for Disease Control and
Prevention, has come to a "general consensus" that a needle-exchange
program would be helpful, said Brian Witt, a health educator with the
Mecklenburg County Health Department.

But until the General Assembly authorizes such programs, all
non-underground implementation is impossible. Democrats in the House
of Representatives have sponsored needle-exchange bills during
several legislative sessions without luck. A bill sponsored by Rep.
Thomas Wright, D-New Hanover, never made it out of committee this
year, though Thelma Wright (no relation) says there's an unlikely
chance the legislature could take it up when they meet for a short
session in May.

Several groups, including the CDC, the National Research Council and
the National Institutes of Health have concluded needle-exchange
programs work. But opposition remains strong among people who believe
the exchanges condone or encourage illegal drug use. "I think some
people can't get past that and look at the public health issue," Witt said.

Even among HIV/AIDS prevention advocates, needle exchange isn't
categorically supported, Hicks said. And such initiatives give drug
treatment professionals even more pause. Flay Lee, clinical program
director at Hope Haven, personally believes needle-exchange programs
can save lives, but said that's not a uniform belief among everyone
at the treatment center.

Alice Harrison, president of Hope Haven, has mixed feelings. Harrison
said she believes exchange programs delay people from getting clean.
"As long as they can continue getting clean needles and using the
drugs, they're not going to get treatment," she said. "I feel like
the needle-exchange programs can make it easier to use drugs without
the fear of contracting disease, which is something that may get
people into treatment."

Still, she said, many users aren't thinking about the consequences of
using dirty needles. "It's hard for me to condone a free exchange
program. . . At the same time, if people are going to be using IV
drugs, then we certainly want to stop the spread (of disease)."

Needle-exchange programs tackle only a small percentage of HIV
infections. Of cases reported in 2004, only nine people listed
intravenous drug use as the sole reason, while five men attributed
their infection to drug use and gay sex, according to county health
department data. But Witt suspects many more people who test positive
may not tell him or other health workers that they shoot up. Last
year, 157 new HIV infections were attributed to "unknown" or "other"
causes. That's nearly half the reported cases.

Wright said she's heard Mecklenburg has a tendency to go it alone.
But she hopes that through advocacy with the Campaign to End AIDS,
she can find a local figure to push the issue. "I've been trying to
get people to understand: This thing is across the board, and it's
the only thing that North Carolina doesn't have in place to stop the
spread of the disease."