Source: New York Times (NY) Contact: http://www.nytimes.com/ Pubdate: Mon, 27 Apr 1998 TO END ABUSE, CLEAN NEEDLES ARE A FIRST STEP To the Editor: Dr. James L. Curtis misses the point in "Clean but Not Safe" (Op-Ed, April 22 (/yr/mo/day/early/04229822curt.html)). While needle-exchange programs are not a cure-all, they allow addicts to lower their risk of H.I.V. infection. As a study published last year in The Lancet found, H.I.V. infection dropped by an average of 5.8 percent a year among drug users in 29 cities with needle-exchange programs but rose by 5.9 percent a year in 51 cities without programs. Exchange programs give addicts in poor and minority communities direct access to the public-health community. This is crucial for directing the neediest addicts toward the drug-treatment programs Dr. Curtis advocates. MIREILLE JACOBSON Cambridge, Mass., April 22, 1998 THEY'LL GET A FIX To the Editor: In "Clean but Not Safe" (Op-Ed, April 22), James L. Curtis writes that "needle exchanges merely help addicts continue to use drugs." It seems fairly obvious that hard-core drug addicts who use needles are suffering from an insidious and overwhelming disease and are going to get their fix with or without these programs. The value in needle exchanges is that they give addicts a safer, cleaner way of using drugs until they come to their senses and seek treatment. MARC D'ANDRE Los Angeles, April 22, 1998 COMMUNITIES AT RISK To the Editor: As a nurse-practitioner who has worked with H.I.V.-infected patients since 1983, I disagree with Dr. James L. Curtis's characterization of needle-exchange programs as "reckless experiments" and "not unlike giving an alcoholic a clean Scotch tumbler to prevent meningitis"(Op-Ed, April 22). Advocates of needle exchanges do not generally deny the importance of "comprehensive treatment," drug rehabilitation or antiretroviral edication. Dr. Curtis identifies himself as a black psychiatrist; all the more reason he should be an advocate of needle exchanges, given that poor black communities are much more adversely affected by a significant increase in H.I.V. infection than the alleged adverse effects of the exchanges. STEPHEN L. RODGERS