Syringe
Exchange
Programs
Grow
in
Scope,
Effectiveness,
Centers
for
Disease
Control
Find
5/25/01
Syringe exchange programs (SEPs) grew rapidly across the country in the mid-1990s, according to a survey published last week by the federal Centers for Disease Control and Prevention in Atlanta. The survey, funded by the American Foundation for AIDS Research (http://www.amfar.org) also found that SEPs are an effective component of a comprehensive strategy to reduce AIDS infection rates. The number of programs, in which injection drug users trade used needles for sterile new ones, nearly doubled in the five-year period, increasing from 68 in 1994 to 131 in 1998, while the number of needles exchanged rose from 8 million in 1994 to 19.4 million in 1998. The SEPS acted as more than mere needle-swaps, however, according to the Beth Israel Medical Center (New York) researchers who authored the study. One out of four SEPs also offered hepatitis testing, two of out three provided HIV testing and referrals, and 95% made referrals to drug treatment centers. This survey is the latest in a growing list of research results that find SEPs reduce HIV/AIDS and do not stimulate illicit drug use. The US Surgeon General last year reported that as many as half of all HIV infections are related to sharing infected needles among drug users. That report concluded that SEPs "are an effective public health intervention that reduces transmission of HIV and does not encourage the illegal use of drugs." The use of SEPS as an AIDS prevention measure has been endorsed by the US Centers for Disease Control, the American Medical Association and the National Institutes of Health, yet they continue to be resisted by critics who view them as encouraging drug use. "There is a history of controversy, but they are becoming much more accepted," project director Mytri Singh of Beth Israel told Reuters. "They don't just provide syringes; they provide a wide variety of services." All of this may be so, but among those results-resistant critics is the US Congress, which has barred federal funds from being used for needle exchange programs. "The largest stumbling block is that the federal government doesn't recognize the scientific evidence and support the programs," said amfAR vice president for public policy Jane Silver. "There has been, however, a significant amount of state, county, and local funding for them." Dave Purchase, head of the North American Syringe Exchange Network (http://www.nasen.org), which worked with Beth Israel to locate active SEPS, only growled when asked about the federal role. "What makes anyone think the federal government has yet learned a thing, at least at the political level?" he asked DRCNet. "All of the progress in SEPs in the United States has been done without one single federal dollar, and we'll keep on keepin' on. By the way," Purchase added, "that study only goes to 1998, and we're doing even better now. Currently we're up to 171 exchange programs in the US." It is a good thing some states and localities have been more enlightened. Public funding accounted for approximately two-thirds of all SEP budgets, the survey found. But it also noted that of the 131 SEPs surveyed in 1998, 80 of them received no taxpayer support. That does not sit well with amfAR board chair Dr. Mathilde Krim. "Public health initiatives that increase access to sterile syringes are needed to decrease the incidence of HIV infections not only among injection drug users, but also their sexual partners and children," she said in a press statement reacting to the research results. Visit http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5019a4.htm to view the study in its entirety online.
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