FOR ALL the success medicine has achieved in treating HIV/AIDS, the United States still isn't doing enough to prevent new infections in the first place. Public health officials have to work with one hand tied behind their backs because Congress has banned the use of federal funds for needle exchange programs. Last week, the NAACP, the Urban League, and other organizations called for Congress to repeal the ban. They are right to do so.
The use of contaminated drug needles is blamed for about one-third of the 40,000 new HIV cases in the United States each year. This method of transmission is especially common among African-Americans, who make up just 13 percent of the US population but accounted for about half of all new HIV cases in 2005.
There are already about 200 needle-exchange programs in the United States, but many more are needed. John Auerbach, commissioner of the Massachusetts Department of Public Health, said that in studies of HIV prevention methods, none has yielded results as positive as needle exchanges. "We know it works," he said. Typically, drug users involved in needle exchanges are also encouraged to get into detox programs.
Repeal of the ban on federal funding would be beneficial in two ways. It would provide money for prevention efforts in communities that get little if any support from their states. And it would go a long way toward reducing community opposition to needle exchanges. Much of that opposition is based on the mistaken belief that making clean needles available to drug users encourages more use of narcotics. But Auerbach said there is "no evidence of any documented increase in drug use because of needle exchanges."
In Massachusetts, there are state-supported needle exchange programs in Boston, Cambridge, Northampton, and Provincetown. Massachusetts cities without needle exchanges, such as New Bedford and Lowell, have historically had much higher rates of HIV cases transmitted by needles than cities like Boston that have such programs.
In 2006, the state repealed the law requiring a doctor's presciption to purchase hypodermic syringes, making it easier for drug users to have access to clean ones. The state would help more communities establish exchange programs, but a state law prohibits DPH from setting up programs in communities that do not want them. The Legislature should amend that law to permit the establishment of programs after DPH consults with local officials, but not necessarily require their approval. AIDS is a public health emergency. On both Beacon Hill and Capitol Hill, lawmakers should ensure that public health officials can fully use this effective means of limiting HIV transmission.
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