Needle Exchange Prevents HIV / Dawn Day and Kendra Wright Published in THE TIMES, Trenton, New Jersey, September 17, 1997, p.A21 Today we are joining with several thousand other women and men who have traveled to Washington, DC, from across the nation to carry an important message to Congress and the Clinton Administration. Heed the scientific findings, we will urge. Follow the advice of our public health experts, we will plead. Fund clean needle programs and slow the spread of HIV/AIDS, we will cry. The spread of drug-related HIV is a terrible problem, affecting thousands already, and with the potential of affecting thousands more. In New Jersey alone, more than 19,100 have injection-related AIDS or have already died from it. A Centers for Disease Control researcher, Dr. Scott Holmberg, estimates that an additional 46,200 people in New Jersey are uninfected but at risk because they inject drugs. Nationally, 190,000 Americans are now living with injection-related AIDS or have already died from it. Across the US, an estimated 1.3 million are uninfected but at risk because they are injecting drugs. Some 11,000 preventable HIV infections will occur by the year 2000 if clean needle programs are not implemented nationally, according to an article published recently in Lancet, a respected medical journal. Infection with HIV/AIDS is not the inevitable death sentence it once was. Among those who can afford the new combination treatments, about a third are helped. So happily there are fewer AIDS deaths now than in the past. But even so, many are still dying and those living with the combination drugs often suffer painful and sometimes incapacitating side effects. For those uninfected and still engaged in injecting drugs, prevention is very important. Prevention is also important for the drug user's wife or husband and newborn children and for the rest of us. We are a society that, medically speaking, shows a concern for all its members. When someone arrives at the emergency room door suffering from a drug overdose, we immediately provide lifesaving medical treatment. We do not withhold medical treatment saying "Drug use is wrong; giving you medical care will send the wrong message." Our society has many ways of sending the message that injecting drugs is a very bad idea, everything from media educational campaigns to prison sentences. But when it comes to a health issue -- slowing the spread of a deadly, infectious disease -- our society must begin to follow the advice of its independent medical experts. The American Medical Association and the American Public Health Association and their New Jersey counterparts have all taken positions that clean needle programs are necessary to reduce the number of HIV infections caused by dirty needles. Six federally-sponsored studies and the National Institutes of Health Consensus Panel have found that clean needle programs curb the spread of HIV and do not increase drug use. Through the caring personal contact that occurs at clean needle program sites, persons who use drugs are sometimes moved to reduce their drug use or enter drug treatment programs. It turns out that clean needle programs are not only a very successful anti-AIDS strategy but also a modestly effective anti-drug strategy. Clean needle programs are pro-family and pro-child. Think of the terror and anguish of the child watching a parent die of AIDS. Consider the terrible loss to family and friends as a young adult, having recovered from an interval of injecting drugs, dies of AIDS just as he begins to blossom and develop his talents. Think of the heartbreaking loss to grandparents, of the grandchildren who will never be born. We cannot continue to pursue policies that permit such tragedies to occur. The American public agrees. A 1996 nationwide survey commissioned by the Kaiser Family Foundation found that two-thirds of Americans support clean needle programs as a way of slowing the spread of HIV among persons who inject drugs. Outdated state laws, like those in New Jersey, that punish clean syringe possession must be changed. Antiquated state laws, like New Jersey's, that prohibit the sale of syringes through pharmacies. must also be eliminated. But today our political attention is focused on the national level. It will be easier to change New Jersey's death-causing laws when federal funds become available. And at least in some states, such as New York and Pennsylvania, the funds could at begin their lifesaving work at once. The Clinton Administration has the power to make funds available for clean needle programs now. It should do so at once. Those in the House who recently voted to ignore the scientific evidence on the effectiveness of clean needle programs and prohibit the use of federal funds for clean needle programs should immediately reconsider for both humanitarian and fiscal reasons. Clean needle programs that prevent the spread of HIV cost less than $2000 per user per year. The combination drugs needed to treat an HIV infected person cost anywhere from $10,000 to $15,000 a year. From a human point of view, we cannot let the pain, suffering and death of the AIDS epidemic spread. From a fiscal point of view, we cannot afford to. For people who inject drugs, the group that now makes up half of all new HIV infections, education alone is not enough. Condoms are not enough. Study after study has shown the effectiveness of clean needle programs. It is vital that we use our HIV prevention dollars wisely. Clean needle programs must become a part of our federal campaign to control the AIDS epidemic. It is a matter of life and death. Dawn Day, Ph.D. is the director of the Dogwood Center in Princeton, New Jersey. Dr. Day is a sociologist and activist scholar who writes on issues of social justice and AIDS. Kendra Wright of Falls Church, Virginia, is the manager of the Families, Women and Children project of Common Sense for Drug Policy.