United Press International - Monday, 13 August 2001
Ed Susman, UPI Science News

Sharing used needles and syringes is one of the major ways in which human immunodeficiency virus (HIV), the pathogen that causes AIDS, is transmitted. Although illegal in many states, some municipalities allow needle exchanges in the belief that such exchanges will prevent the spread of disease.

In New York City, that is apparently what has occurred, said Dr. Don Des Jarlais of the Beth Israel Medical Center. "Large scale syringe exchange and HIV voluntary counseling and testing programs appear to have 'reversed' the HIV epidemic among injecting drug users in New York City," Des Jarlais said.

The AIDS epidemic among injecting drug users reached a peak of 50,000 infected persons, making it one of the largest local epidemics in the world. The epidemic began in the late 1970s and swept through the needle-sharing population of the city.

By 1983, he said, as many as 50 percent of the 200,000 drug users in New York City were infected with HIV. That number remained constant through 1991, Des Jarlais said. A needle and syringe exchange program was initiated in 1992. About 40 to 50 percent of the injecting drug users took advantage of the program.

When Des Jarlais and colleagues analyzed the latest data, they found that about 20 percent of the drug users are infected. Until the initiation of the needle exchange program, about 4 to 5 percent of the drug users were becoming infected each year, he said. Now, he said, new infections are down to about 1 percent a year. During the height of the epidemic, about 4 to 5 percent of the injecting drug users died from AIDS and other causes each year. The prevalence remained about 50 percent during the period because those people who died were replaced by about 4 to 5 percent of new infections, Des Jarlais explained.

"This is a major success story in terms of the prevention of HIV infections in the United States," he said.

"Perhaps the most remarkable success in prevention has been among injection drug users," said Dr. Helene Gayle, director of the National Center for HIV, STD and TB Prevention of the Centers for Disease Control and Prevention, Atlanta.

"Still given these successes, we have to ask ourselves," Gayle said, "how many more lives could be saved, how many more infections among injection drug users could have been prevented if we had a national commitment to use everything science has shown us can make a difference for this population."

Needle exchange programs are still missing from the boroughs of Queens and Staten Island, and are not well established in Brooklyn, Des Jarlais said. A citywide program could cut the new infection rate to about one-half or one percent, he suggested. Because of opposition to needle exchange programs and centers in certain neighborhoods, he said, the State of New York has created legislation that allows the purchase of needles and syringes without a prescription in pharmacies.

Nationally, the number of sanctioned needle exchange programs has increased from about 40 in 1990, to about 160 in 2000, Des Jarlais said. However, there is no federal funding for needle exchange programs. Cynthia Gomez, director of the Center for AIDS Prevention Studies at the University of California, San Francisco, said, "There is no reason why needle exchange programs should not be fully funded -- beginning today."
010813
UP010805

Always watch for outdated information. This article first appeared in 2001. 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, 2001. 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. .