San Francisco Chronicle - Friday, August 3, 2007
Heather Knight, Chronicle Staff Writer

The city's needle-exchange program gives out 2.4 million needles a year and receives 65 to 70 percent of them back after they're used. Other cities - including Portland, Seattle and jurisdictions throughout New Mexico - have return rates of well over 90 percent.

In San Francisco, The Chronicle reported recently, many unreturned needles wind up in parks, playgrounds and other outdoor expanses.

"We can recover a lot more needles," said Mark Cloutier, executive director of the San Francisco AIDS Foundation, which runs most of the city's needle-exchange sites. "We understand it's a public health problem, and we're excited about the attention that's happening."

Cloutier said a locked, 24-hour biohazard drop box will be installed on Sixth Street within the next six weeks. It will be available for anonymous needle drop-off any time, sort of like drop boxes for library books or rented movies. The AIDS Foundation likely will test it for six months but expects to open others around the city.

"We're not going to put it in the middle of Union Square," he said. "It's where people can experience some anonymity."

As it is now, injection drug users usually return their used syringes during the hours needle exchanges or health clinics are open. The AIDS Foundation operates seven exchange sites around the city, each of which is open two to four hours a week.

Public health officials also will meet soon with manufacturers of retractable syringes - in which the needle fully retracts into the syringe's barrel after one injection. These are considered much safer than the syringes commonly used and would prevent children or others who pick up dropped syringes from infecting themselves.

The retractable syringes cost seven times more than the common ones - an average of 35 cents compared with 5 cents - but might prove to be worth the extra money, according to Dr. Mitch Katz, the city's public health chief.

Supervisor Ross Mirkarimi still has some retractable syringes in his office desk - left over from the board's discussion two years ago of switching to the new syringes. At the time, they were deemed too pricey.

Mirkarimi said Thursday that he thinks the Public Health Department has been slow to deal with the needle problem but that a switch to retractable needles would be better late than never.

"This would be an apt opportunity for the city to pursue this option," he said.

Other options are on the table, too.

Tracey Packer, interim director of the health department's HIV Prevention Program, said officials are looking at providing homeless outreach workers with biohazard boxes to carry with them, giving users of the needle-exchange programs small biohazard packs that can carry 10 used needles at a time and better educating users about needle safety.

Packer said the city needs more drop-off sites, and fire stations and soup kitchens could be good options.

The San Francisco needle-exchange program was begun in 1992 under Mayor Frank Jordan. The Public Health Department contracts with the AIDS Foundation, the Homeless Youth Alliance and Tenderloin Health to run the exchanges at a total of $850,000 a year.

But, as reported recently by The Chronicle, not everyone is returning the needles, and parents are sharing horror stories about their children finding needles in parks and playgrounds.

Supervisor Bevan Dufty said Thursday he successfully advocated for the closure of a play area at the Eureka Valley Recreation Center because children were finding needles in the sand.

"I have a child, and I want my child to be able to play in the sand, but I no longer felt comfortable having a playground feature be dangerous like that," he said. "I'm open to ideas."

Mayor Gavin Newsom last week asked Katz to come up with ways to make needle disposal easier and safer. The issue is politically tricky because disease prevention and social services are important to San Franciscans, but so are public safety and clean parks and playgrounds.

"This is a difficult situation, but we can't end our needle-exchange program," said Newsom's press secretary, Nathan Ballard. "It saves lives."

The health department is looking at needle-exchange programs in Portland, King County, Wash., which includes Seattle, and the entire state of New Mexico. Drop boxes seem to have proven especially effective.

New Mexico began its program in 1998 and has 24 drop boxes around the state, mostly outside health department offices and nonprofits. It's about to get six more.

Bernie Lieving, who works in the state's public health department's infectious disease bureau, said the drop boxes have been popular not only with intravenous drug users but also with diabetics and others who use needles for medical reasons.

"They're available 24 hours, they're locked, they're bolted to the concrete," he said. "The only problem we've had is people backing into them with cars."

The drop boxes have helped the department achieve a 97 percent return rate - and have never been vandalized.

"Why would somebody want to break into a medical waste box and get out used syringes?" he asked. "That doesn't make sense."

One thing just about everybody associated with the needle-exchange program in San Francisco agrees on: It is saving lives and will continue as a city program.

Cloutier said six years ago, 16 percent of new cases of HIV in the city were attributable to injection drug use. Now, the figure is down to 0.5 percent.

"We have proven in San Francisco that this largely solves the problem," he said. "Needle exchange has been enormously successful."
070803
SC070803

Always watch for outdated information. This article first appeared in 2007. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2007. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .