Needle-Exchange Programs To Prevent HIV Cases Among IDUs

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Needle-Exchange Programs

Washington, D.C., should be allowed to fund needle-exchange programs to prevent the spread of HIV among injection drug users in the city, Steve Chapman, a member of the Chicago Tribune's editorial board, writes in a Tribune perspective piece. The House this week is expected to vote on a bill that would allow the district to "decide for itself whether to spend its own dollars to hand out" clean needles and syringes, according to Chapman (Chapman, Chicago Tribune, 6/17).

The House Appropriations Committee recently approved a $21.4 billion appropriations bill that would lift a ban on city funding for needle-exchange programs in the district. The House Appropriations Subcommittee on Financial Services and General Government earlier this month voted to remove language from the bill that prevents the district from financing the programs. The ban was first imposed under a federal law signed by former President Clinton in 1998 that prohibits the district government from using local tax money to fund any organization that operates a needle-exchange program. The House has added the ban each year to the district's appropriations bill.


Rep. Jose Serrano (D-N.Y.), chair of the subcommittee, recently said he would make it a priority to push for removal of the language. District Mayor Adrian Fenty has said that he will provide funds for needle-exchange programs as soon as Congress removes the language.

Injection drug use is the second most common mode of HIV transmission among men in the district and the most common mode among women in the city. Prevention Works!, the district's only needle-exchange program, is financed through private donations and reaches about one-third of the estimated 9,700 injection drug users in the city (Kaiser Daily HIV/AIDS Report, 6/13).

Although the federal government "spends some $15 billion a year on health care and financial assistance for AIDS patients," it "refuses to lay out one thin dime for" needle-exchange programs, Chapman writes. He adds that although there are studies that "fail to vindicate" the programs, they are "rare and unrepresentative." In addition, the "strong consensus" among experts is that exchange programs have "proven their value beyond dispute."

Funding bans on needle-exchange programs are "not the only impediment," according to Chapman. Scott Burris, a law professor at Temple University, says that 23 states have laws that deter or prohibit pharmacies from selling syringes without a prescription, Chapman writes. Some district HIV/AIDS advocates say the city is "guilty of the same mistake," Chapman adds. While the district is "asking for help from Congress on needle exchange, it could help itself by deregulating" over-the-counter sales of clean needles, according to Chapman. "Restrictions on the sale and possession of injecting equipment, like the funding bans, make it harder for drug users to take basic self-preservation measures," Chapman writes, concluding, "If you like throwing away money, preventing addicts from getting access to sterile syringes is an excellent strategy. If you like squandering lives, it's even better" (Chicago Tribune, 6/17).

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