PAGE 4 T Q-Notes T October 4, 1997
Officials stress need for needle exchange at AIDS conference
by Mark Aurigemma
Special to Q-Notes
MIAMI BEACH—During the recent US
Conference on AIDS (USCA), held Septem
ber 18-21, public health officials and policy
experts from several states met to discuss a grow
ing trend, in the absence of federal leadership,
toward states developing their own needle ex
change programs to slow HIV transmission.
While the Clinton administration has re
fused to approve federal funding for clean sy
ringe programs, the US House of Representa
tives voted the week before the Conference to
prohibit it from doing so. State officials at the
meeting asserted that growing evidence shows
that needle exchange programs reduce HIV
transmission without increasing drug use. The
states’ case studies were presented in an insti
tute on HIV/AIDS and Injection Drug Users
held the first day of the National Minority
AIDS Council-sponsored gathering.
Experts at the program stated that, while
progress has been made in slowing the HIV
epidemic in some areas, transmission through
the use of contaminated needles continues to
grow, particularly within communities of color
and poorer communities, and among women.
More than half of the AIDS deaths among Af
rican-Americans are injection related. As of
December 1996, nearly 100,000 African-
Americans had contracted AIDS through in
jection, including 30,000 African-American
women.
Some officials discussed the mounting frus
tration felt at the state level over the unwilling
ness of the Clinton administration and the
House of Representatives to approve federal
funding for needle exchange. By a vote of 266
to 158, the House passed an amendment to
the $270 billion Labor-Health and Human
Services appropriations bill to remove the abil
ity of the Health and Human Services (HHS)
secretary to allow local communities to use fed
eral funds for needle exchange programs. The
amendment was written by Rep. Tom Coburn
(R-OK) and introduced by Reps. Dennis
Hastert (R-IL) and Roger Wicker (R-MS).
Apart from the Conference, officials at the
nation’s largest AIDS advocacy organizations
loudly decried the vote by the House — which
came on the heels of a report from the US Cen
ters for Disease Control noting that AIDS
deaths fell by 26 percent last year. The irony
wasn’t lost on Daniel Zlngale, executive direc
tor of AIDS Action. “As we stand at the most
critical crossroad in the epidemic, the House
tragically held up a green light to increased
AIDS deaths. This grave act of irrationality
could cost thousands of lives.”
Julie Scofield, coordinator of the Conference
institute and executive director of the National
Alliance of State and Territorial AIDS Direc
tors, said, “We have to continue our efforts at
the national level to educate legislators on the
value of needle exchange and sterile syringe
programs. But we can’t wait while thousands
of lives are at stake in communities across the
country.”
While some state needle programs began as
illegal efforts, presenters illustrated how several
state legislatures have now legalized clean needle
prograths.
“Leading Rhode Island pubic health offi
cials, along with many other state officials, be
lieve the government should repeal the fimd-
ing ban on needle exchange,” said Paul G.
Loberti, chief administrator of the Rhode Is
land Department of Health Office of AIDS.
“But states should not wait for the federal gov
ernment to support needle exchange. States
without needle exchange should begin the step-
by-step process of introducing the important
public health significance of creating access to
clean injecting equipment.”
Loberti reported that approximately 50 per
cent of all AIDS cases in his state are a result of
injection drug use. He also told the USCA In
stitute that institutions such as the Rhode Is
land Medical Society now support fully funded
needle exchange programs and the repeal of
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State laws restricting access to clean syringes.
Geoff Beckett, Maine’s assistant state epi
demiologist, discussed how his usually conser
vative state came to approve sterile syringe pro
grams. “The arguments for making sterile sy
ringes available are very strong. When the is
sues are brought into the light of day, in an
open discussion, many individuals who would
not be expected to support these programs ac
tually do. Maine’s sterile syringe program has
the support of the state’s chiefe of police and
pharmacists association.”
A Minnesota proposal to authorize the legal
sale of ten or fewer syringes and to start a new
clean syringe program passed this year with the
support of the governor and the Minnesota
Department of Health. At the institute. Bob
Tracy, public policy direaor for the Minnesota
AIDS Projea, said, “Minnesota, like Maine, has
a relatively low level of injection drug related
HIV infections. However, the growing presence
of heroin in this area signaled we may be at the
beginning of a much larger injection drug re
lated HIV epidemic. Minnesota had to take
action to prevent this. In the face of overwhelm
ing public health evidence supporting clean
syringe availability, Minnesota could not wait
for the federal government to aa.”
Another conservative state. New Mexico,
recently moved to allow clean syringe programs
to operate there. “We were able to demonstrate
that New Mexico had a small window of op
portunity to prevent a major injection related
HIV epidemic in the state,” said Don Torres,
chief of the HIV Bureau for the New Mexico
Department of Health.
“At the time the state aaed, injection drug
users in New Mexico had hepatitis rates of 80-
90 percent, proving they were sharing needles.
But only one percent had HIV at that point.
All it would have taken was the introduction
of HfV into this population and, absent a ster
ile syringe program, we would have had an ex
plosion of new HIV cases. We could not wait
for the federal government to recognize this is-
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