LACK OF NEEDLE EXCHANGE PROGRAMS MAY HAVE PERMITTED 10,000 PREVENTABLE HIV INFECTIONS IN THE U.S, SAYS UCSF STUDY Copyright (c) 1997, Business Wire, Inc. Business Wire March 3, 1997 March 3, 1997 Needle exchange programs could have prevented nearly 10,000 HIV infections among injecting drug users, their sex partners and their children in the United States since 1987, according to a University of California San Francisco study published in the March 1 issue of the medical journal The Lancet. Expanding the Lancet study data, the authors reported today (March 3) specific data for 16 of the largest cities in the United States, estimating that the number of preventable infections range from 2,308 in New York City to 14 in Gary, Ind., for 198795. Treatment costs related to these infection rates are calculated at $ 128,417,120 for New York City and $ 778,960 for Gary. Estimates of preventable HIV infection for other U.S. cities are Atlanta, 186; Baltimore, 499; Boston, 182; Chicago, 561; Dallas, 39; Detroit, 152; Houston, 260; Los Angeles, 95; Miami, 297; Newark, N.J., 397; Philadelphia, 641; San Juan, PR, 315; Seattle, 48; and Washington, D.C., 646. If needle exchange programs (NEPs) were established now, study coauthors say an additional 11,300 HIV infections could be prevented in the United States by the year 2000. "Removing the U.S. government ban on NEP funding and accelerating the growth of NEPs in the U.S. are public health priorities as urgent as any in the HIV epidemic," stated coauthors Peter Lurie, M.D., MPH, a researcher at the UCSF Center for AIDS Prevention Studies, and Ernest Drucker, Ph.D., professor of epidemiology and social medicine at Montefiore Medical Center/Albert Einstein College of Medicine, New York. The team determined estimates for both the Lancet study and the additional analysis of the 16 cities based on a formula that accounted for NEP effectiveness, how often injecting drug users use NEPs, sexual transmission of the virus among them, and secondary HIV transmission to their sex partners and children. They obtained data from published epidemiological and mathematical studies, government reports and consultations with needle exchange researchers and drug abuse experts. As a model for their analysis, the researchers used the Australian NEP system, which receives substantial government support. Australia initiated a system of NEPs in 1987, early in the AIDS epidemic. By 1995, 50 percent of Australian injecting drug users were receiving clean needles through programs at least once a month. Lurie and Drucker estimated that the number of HIV infections that could have been prevented in the United States by NEPs between 198795 is between 4,394 and 9,666, depending on how effective NEPs are assumed to be. Of these infections, 88 percent would have occurred among injection drug users, with the remainder among their sex partners and children, according to the study. The researchers based cost calculations on the most conservative estimate of the current lifetime cost of treating an HIV infection $ 55,640 which does not take into account treatment with the new, expensive protease inhibitors. The cost of treating the preventable HIV infections that occurred between 198795 ranges from $ 244 million to $ 538 million, enough to have funded 161 to 354 NEPs, the study reports. "There are now seven federal governmentfunded reports concluding that NEPs can prevent HIV transmission without increasing drug use," Drucker said, adding that he believes study estimates are conservative. "Injection drug use is the number one cause of HIV infection in the U.S.," Drucker said. By revoking laws that ban federal funding for NEPs, as well as those state laws that impede pharmacy access to sterile syringes, "we can still greatly reduce the number of HIV infections that will otherwise occur possibly preventing more than 11,000 additional HIV infections by the year 2000 if we act now," Lurie said. 0 NOTE TO EDITORS: Media wishing to interview the coauthors and to receive a copy of the study or spreadsheets for one or more of the 16 cities should call UCSF News Services, 415/4762557. CONTACT: University of California, San Francisco Rebecca Higbee, 415/4762557