CUTTING FUNDS FOR CITY'S LIFE POINTS PROGRAM WILL DOOM MANY TO AIDS, OTHER
INFECTIONS

Drugs and sex are leading commodities in Cass Park: sex for drugs or sex
for money to buy drugs. It's a virtual laboratory for HIV. Clean needles
and condoms become survival kits.

But programs in which addicts swap their dirty needles for clean ones
are dying. Five years after former President Bill Clinton banned
federal dollars for them, money from cities and foundations is drying
up. Needle exchange programs in Detroit and across the country are in
big trouble.

On the street, this is a matter of life and death.

I spent one afternoon in Cass Park, and another on the corner of Mack
and Bewick, talking to intravenous drug users with health worker Harry
Simpson.

They came with scarred skin. Some had thick abscesses. Most looked at
least 10 years older than they were.

None had health insurance or much contact with the health care system,
other than the emergency room at Detroit Receiving.

Simpson, who helps run the Life Points needle exchange program for the
Community Health Awareness Group in Detroit, is a nationally known
expert on AIDS prevention in minority communities. He's also a former
heroin addict who knows what it's like to want a fix so bad you feel
like you're going to die.

Over the past four months, Simpson has hit the streets and
interviewed, anonymously, about 200 injection drug users in five
cities as part of a state HIV/AIDS prevention and intervention study.
One thing is clear from the dozen people I listened to: Many users,
caught up in their addiction, will risk contracting AIDS, even though
they know how to prevent it.

A 43-year-old prostitute who shoots heroin about 40 times a week told
us she wants her tricks to use condoms. But if they refuse, she goes
along, for the money. She tries to use clean needles when she shoots
up, but if one isn't handy, she'll use a dirty one.

Asked if protecting herself from HIV was ever more important than
using drugs, she looked embarrassed.

"Sorry to say, but no," she said.

That's why it's vital for her to get clean needles and syringes. On
the day Simpson spoke to her, she stepped into the Life Points van,
pulled a handful of dirty needles from a small purse and received an
equal number of clean ones. Some people came with their needles in
hand or in a plastic bag. The exchange is always one-to-one. If you
turn in 25 dirty needles, you get 25 clean ones. Most people also pick
up free condoms.

Drug users in the Cass Park area know to look for the silver Life
Points van on Mondays, from 3 p.m. to 5 p.m., and Thursdays, from 5
p.m. to 7 p.m. The van goes to 10 sites at regular times around the
city.

Intravenous drug users, their sexual partners and their children
account for nearly half of the nation's new HIV cases. Detroit, with
10 percent of Michigan's population, has 44 percent of its 15,500 HIV
and AIDS cases.

Studies have shown that needle exchange programs reduce the rate of
HIV among injection drug users by 50 percent, while not increasing
drug use. Every major public health group has supported them.

Still, needle exchange has become a dirty word in Washington. Under
the Bush administration, health officials have warned scientists who
research AIDS that even the term "needle exchange" could cause their
grant applications to come under heavy scrutiny by the Department of
Health and Human Services or members of Congress.

Critics say needle exchange programs promote, or sanction, drug use.
They do not. They simply reduce the risk of contracting and spreading
a deadly disease. They keep people alive until they're ready to go
into treatment.

In fact, in the most real way, needle exchange programs discourage
drug use. The workers who go out on the street, meeting addicts on
their own turf, are the only regular contact many drug users have with
the health care system. In Detroit, most needle exchange workers are
former addicts. They don't look down on their clients or make them
feel even worse about themselves. They call them "brother" and
"sister," and mean it. You don't get to an addict by handing out
pamphlets. You have to build relationships of trust.

Life Points has more than 2,500 drug users signed up for services, and
its workers have gotten 20 percent of their clients into treatment.
Without regular contact with these workers, most of them would not
have made it.

Still, the Life Points budget, $216,000 last year, will be cut in half
this year. That will mean fewer sites and a 50-percent drop in
services, said Cindy Bolden Calhoun, executive director of the
Community Health Awareness Group.

Life Points lost a $25,000 grant from the TIDES Foundation and has not
gotten the $89,000 it received last year from the city of Detroit. The
Michigan AIDS Fund has also reduced funding because it has less money
to give.

Budget cuts for the needle exchange program will be a death sentence
for some of Detroit's 40,000 injection drug users. If saving lives
doesn't sway you, consider this: treating an AIDS patient costs more
than $100,000 a year.

Truth be told, the City Council can withhold further funding and not
feel any heat. Times are tough, and the people who gather in Cass Park
or around the liquor store at Mack and Bewick don't have a voice.

That said, $89,000 is chump change for any large city. On what else
could the council spend so little and do so much?

Five years ago, Clinton acknowledged that needle exchange programs
saved lives but left it to cities and private charities to support
them. In other words, he punked out.

Now it's up to cities like Detroit to step to it or watch their No. 1
public health problem just get worse.