San Francisco Chronicle - Monday March 13, 1989
Lori Olszewski, Chronicle Staff Writer

The 20-member group, which calls itself Prevention Point, has been risking arrest since November to check the spread of AIDS among intravenous drug users on the streets of the Tenderloin and other neighborhoods.

"I am here to save lives. I don't care if I have to go to jail," said Tia Wagner, 30, of San Francisco during the group's first interview.

A number of city leaders, including Dr. David Werdegar, director of San Francisco's Department of Public Health, say they are cautiously supportive of needle exchange under the right conditions. But they stop short of committing themselves to such a program for San Francisco.

While the experts study the issue, Prevention Point's activities remain illegal because California law says it a misdemeanor to possess syringes without a prescription. The offense is punishable by up to six months in jail and a $1,000 fine.

The legal gamble is worth it to Wagner and the others who distribute needles weekly at three sites in San Francisco - near Boeddeker Park in the Tenderloin, around the Civic Center and in the South of Market area under the freeway.

Wagner watched her mother, a lifelong heroin addict, die of AIDS at the age of 50 on Christmas Eve two years ago.

"I lost a parent to this because the bureaucracy sits around and talks while lots of people are dying," Wagner said.

One day a week, for two hours, Wagner quietly moves through the Tenderloin, telling heroin, speed and cocaine addicts where to find her colleagues who are discreetly holding clean needles and a container for infectious waste hidden in a basket.

Other teams work different neighborhoods. As the word passes through the neighborhoods served by the volunteers, more than a hundred addicts in one shift may deposit needles in the container.

"Everyone knows when and where to come," said one drug addict who uses the Tenderloin exchange. "We just keep moving and watch for the police."

During the past four months, Prevention Point has provided 1,336 clean needles to people who must exchange a dirty needle for every clean needle they receive. No one can receive more than seven needles during the weekly exchange.

The six-person teams also provide AIDS education and counseling. And they alert their anonymous clients that the needle exchange is not legal.

'WE HAVE ALL LOST SOMEONE'

"We have all lost someone (to AIDS)," said Rose Dietrich, 41, the other San Francisco resident from Prevention Point who is willing to go public. Her eyes filled with tears as she said, "This was something to do with our anger."

A growing number of cities, including New York and Tacoma, Wash., have adopted legal needle exchange programs as one strategy to reach addicts who continue to risk infection from the AIDS virus by sharing needles.

San Francisco, known as a model of AIDS treatment and prevention around the world, was one of the first cities in the nation to encourage bleach distribution among addicts to disinfect needles. Although San Francisco health officials discussed a needle exchange program in 1986, it was crushed by then-Mayor Dianne Feinstein, who called it "terrible and truly offensive."

Today, anywhere from 13 to 20 percent of San Francisco's estimated 10,000 to 13,000 drug addicts - between 1,300 and 2,600 people - already are infected with the human immunodeficiency virus, according to various studies. Each of them has the potential of spreading AIDS by sharing contaminated needles.

Despite widespread AIDS education, drug addicts "are still using and they are still sharing," said Wagner, a recovering drug addict.

FURTHER SPREAD

Infected drug addicts have the potential of spreading the virus to their sexual partners. Pregnant women also can pass HIV infection to their babies.

"We need to put the needle exchange issue back on the front burner of San Francisco," said Les Pappas, campaign development coordinator at the San Francisco AIDS Foundation, the lead AIDS education agency in the city.

He said the AIDS Foundation hopes to return the issue to prominence with a forum on needle exchange that it is sponsoring on Friday at the San Francisco Department of Public Health. Pappas and others are also encouraged that Dr. Louis Sullivan, the new secretary of Health and Human Services, said last week that he is supportive of community needle exchange programs.

"The lack of political leadership is what gets people frustrated enough that they feel compelled to do something like the underground program," Pappas said.

Health director Werdegar said: "I support the concept of needle exchange under the proper conditions, as a demonstration project with the proper legal approvals and community consensus."

Scott Shafer, assistant press secretary to Mayor Art Agnos, also responded cautiously. "The mayor thinks it is often better to move thoughtfully than to move quickly," he said.

HIV TASK FORCE

Agnos' HIV Task Force, chaired by Dr. Donald Francis, the national Centers for Disease Control's AIDS adviser to California, is studying the needle exchange issue, Shafer said.

Werdegar also expressed concern about political opposition like that which surfaced from black and Hispanic leaders in New York to that city's needle exchange program. Those critics said such a program sends the wrong message about drug abuse to minority communities facing devastation from widespread drug addiction.

Although some of the Prevention Point volunteers are AIDS workers, Wagner and Dietrich stress that they and the others are not doing their illegal work on any organization's time. They also will not discuss how they obtain the needles, except to say they are not illegally diverting them from prescriptions. They have spent about $450 from private donations to do their work.

Prevention Point, like most San Francisco AIDS programs, began with friends meeting in kitchens and living rooms, Dietrich and Wagner said. Group members range from housepainters to lawyers. Some are infected with the AIDS virus.

Wagner said they do not know whether the police are looking the other way. Added Dietrich: "We expected to be arrested, but we weren't."

CAPTION: PHOTO

Tia Wagner and Rose Dietrich paused from their work in the underground AIDS prevention needle exchange program in San Francisco /BY DEANNE FITZMAURICE/THE CHRONICLE

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