Pubdate: Tue, 05 Jun 2001 Source: Pittsburgh Post-Gazette (PA) Copyright: 2001 PG Publishing Contact: http://www.post-gazette.com/ Details: http://www.mapinc.org/media/341 Bookmark: http://www.mapinc.org/find?137 (Needle Exchange) COUNTY OFFICIALS SHOULD APPROVE NEEDLE EXCHANGES Needle exchanges for intravenous drug users, most notably administered by Prevention Point Pittsburgh, have operated in Allegheny County for many years, but outside the law. Because it is illegal, any effort made to prevent the spread of AIDS through dirty needles carries with it the risk (though seldom realized) of arrest. That may finally change sometime later this year if the county Board of Health decides to declare a state of emergency and implement an official, legal needle exchange program. Philadelphia took such a step years ago. While the numbers are still low, the local board was alarmed by a doubling in the incidence (from 9 to 18) and rate (from 0.7 percent to 1.5 percent) of HIV infection among intravenous drug users. As difficult as it is to accept the notion of enabling illegal and self-destructive behavior, the evidence is convincing and growing that needle distribution reduces the rate of HIV infection without increasing drug use. Many reasonable and decent people appalled by the thought of giving a needle to an addict, argue that it would be much better to focus energies instead on drug treatment. But the data suggest that the two can go hand in hand. Through needle exchanges, health departments can also provide information about treatment, screening services and health care. The clean needle is a way to keep the patient alive until the treatment has a chance to work. The choice is not between shooting up with a clean needle and kicking the habit. It is between shooting up with a clean needle or one that is infected. Any public health agency true to its name would have to provide the clean needle. The state Health Department is not in favor of such programs, unable apparently to get past the negative image to the reality of the positive effect needle exchanges have in stemming the growth of HIV infection. That's too bad. Luckily, the county does not have to get permission from the state to protect the health and well-being of its citizenry. The county Board of Health has already moved beyond the state in requiring that all diagnosis of HIV infection be reported to the Health Department. In the coming months and years, the state will have a real idea of just what is happening and how to react. The fact that the county was willing to take the lead on this is a very good sign. Knowing the numbers is important, but it is secondary to bringing them down. Clean needle exchanges, complete with Health Department services, is a proven way to accomplish that. - --- MAP posted-by: Josh Sutcliffe