NEEDLE EXCHANGE PROGRAMS STRUGGLE WITH FUNDING

NEW HAVEN, Conn. -- With her grayish hair and pink sweater, retired
teacher Joanne Iannotti looks like a typical grandmother as she
emerges slowly from her home with a little bag of dirty hypodermic
needles.

She shuffles to a van and exchanges her bag for clean needles for her
adult sons, who she says shoot heroin with their friends.

"They tend to want to share," Iannotti said. "I say, 'No, wait. I have
clean needles for everybody."'

Iannotti participates in one of nearly 200 needle exchange programs in
the United States. A growing body of research has found that needle
exchange programs reduce the spread of AIDS without increasing drug
use.

But local budget cuts and a federal ban on funding such programs in
the U.S. and abroad are hurting the programs at a time when injection
drug use is fueling a global AIDS epidemic, advocates say.

"Funding for needle exchange programs in the United States has always
been difficult because the governmental bodies have never wanted to
support what they see as a morally slippery intervention," said Dr.
Peter Havens of the Medical College of Wisconsin.

Physicians for Human Rights held congressional briefings last week to
build support for needle exchange and other programs to prevent the
spread of AIDS among drug users. The group also wants the U.S. to lift
constraints on programs that receive U.S. funding so they can
collaborate with needle exchange programs funded by other donors.

About one-fourth of the nearly 950,000 AIDS cases in the U.S. through
2005 involved injection drug use, according to the Centers for Disease
Control and Prevention. The rate is even higher in many other
countries, experts say.

Critics say needle exchange programs encourage risky behavior and work
against efforts to fight drug abuse.

But countries in Europe and Asia have increasingly recognized the
benefits of needle exchange programs, Havens said.

After several studies, then-Health and Human Services Secretary Donna
Shalala determined in 1998 that such programs reduce the transmission
of HIV and do not encourage the use of illegal drugs.

"They work," said Ricky Bluthenthal, senior social scientist at Rand
Corp., who has studied the programs in Connecticut and other states.
"The evidence in support of them is quite strong."

The New Haven program was touted as a national model after a Yale
University professor in the early 1990s was among the first to
document the effectiveness of providing clean needles to slow the
spread of the HIV virus that causes AIDS.

George Ducheli and Ambritt Lytell-Myers, who drive the program's van,
are convinced they are saving lives. Both are recovering drug addicts.

"They're going to get high anyway," Ducheli said. "We're just keeping
them from getting infected or infecting others if they are already
infected."

In addition to proving clean syringes, they try to connect drug users
with treatment.

Iannotti said one of her sons was getting violent, had wrecked cars
and even stole her funeral money. But Ducheli arranged for him to get
into treatment last week.

"His mood is completely different," Iannotti said. "He wants to stay
longer."

A proposed state budget would cut about $100,000 from the $500,000
spent on needle exchange programs in New Haven, Hartford, Danbury,
Stamford and Bridgeport. That cut would make it difficult to operate
the New Haven program and could lead to elimination of some of the
other programs, officials said.

"You're talking about trading lives for $100,000," said David
Purchase, chairman of the North American Syringe Exchange Network.