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the San Francisco Chronicle

US Needle Policy Hurts AIDS Sufferers


Today, the African American community will gather under the banner of National Black HIV/AIDS Awareness Day to bring attention to this modern plague and its disparate impact on the black community.

While HIV/AIDS decimates our community, our nation has failed to implement a national health policy that addresses how this disease is spread. Nowhere is this discrepancy as great as over the issue of needle exchange.

Needle exchange remains a scientifically proven strategy to curb the spread of AIDS by providing clean needles and access to treatment for injection drug users. Unfortunately, for nearly 20 years Congress has maintained a no-longer-rational ban on the use of federal dollars for needle exchange programs. Congress thinks differently than health professionals and organizations such as the Black AIDS Institute, National Minority AIDS Council, NAACP, National Urban League, American Academy of Pediatrics; American Bar Association, American Medical Association and U.S. Conference of Mayors.

These groups see needle exchange as a viable means of slowing the spread of the virus. Nearly a quarter of the annual 40,000 new cases of HIV/AIDS in this country are either a direct or collateral effect of intravenous drug use. The failure to have access to clean needles has wide-ranging implications not just for drug users, but also for their families and entire communities. Up to 75 percent of new AIDS cases among women and children are directly or indirectly a consequence of intravenous drug use.

If most Americans knew, by simply removing a political plank in congressional appropriation bills, that we could reduce the spread of HIV/AIDS in the United States by up to one-third, they would run to their congressional representative's office and demand answers. They would want to know why our elected officials ignored a proven strategy to prevent the spread of HIV - a strategy that has already been approved by 16 counties and four cities in California, as well as in more than 20 nations from Europe to Canada.

Due to the federal ban on syringe exchange enacted in 1988, states and cities have been limited to using scarce local funds to combat the damage that results from intravenous drug users sharing HIV-infected needles.

According to the Harm Reduction Coalition, more than 200 needle exchange programs exist in 36 states, and their impact on reducing the spread of HIV and Hepatitis C has been amazing. According to a 2005 study of New York City HIV trends, the number of HIV positive injection drug users dropped more than 75 percent from 1990 to 2001. Similarly, a 1997 study in The Lancet medical journal compared HIV infection rates among injection drug users in 81 cities around the world. In the 52 cities without needle exchange programs, the rates increased on average 5.9 percent annually; yet in those 29 cities with needle exchange programs, HIV rates dropped 5.8 percent annually.

Health experts have called for allowing federal dollars for needle exchange programs. Advocates for removal of the federal ban cheered when Congress voted to allow the District of Columbia to use its own funds to support syringe exchange programs. In California, Gov. Arnold Schwarzenegger signed into law similar legislation that, after 20 years, finally provides local jurisdictions greater autonomy in using funds to support syringe exchange.


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Countless studies have documented the benefit syringe exchange programs have had on reducing HIV/AIDS rates across the globe and here in California, which hosts 39 syringe exchange programs.

Sadly, for African American and Latino communities, the problem of HIV/AIDS has already reached the crisis level. Today, African Americans make up only 12 percent of the national population but the majority of new AIDS cases. Additionally, African Americans make up 50 percent of AIDS cases attributed to drug injection use, while Latinos make up 25 percent.

These horrific numbers could lead many to see the federal ban on syringe exchange programs simply as a "minority" issue instead of the national public health policy issue that it is.

As law professor Lani Guinier noted, America's minority communities often serve as "the canary in the coal mine" for social maladies. Why would health problems facing these communities not eventually impact each and every neighborhood? Already reports from the CDC indicate that yearly HIV/AIDS infection rates could actually be 20 percent to 50 percent higher than previously estimated.

On National Black HIV/AIDS Awareness Day, ours is not a call from the African American community alone. It is a call from advocates the world over, whose communities are plagued by an epidemic and who seek resources for the fight.

Removing the federal ban on syringe exchange programs makes sense economically, politically and morally. Better public policy must not be strangled by Beltway politics - after all, we are talking about people's lives.

James E. Loyce Jr. is the executive director and Adrian Tyler is the director of development and communications for the Black Coalition on AIDS in San Francisco. Malik Russell is the communications coordinator for the Harm Reduction Coalition, West Coast office .

© 2008 San Francisco Chronicle

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