By Alex Hudson
Drug Information Center Coordinator
This week’s column is in honor of World AIDS Week, which everyone who’s anyone already knows it is. HIV/AIDS and drug use have always been pretty closely linked, and due to the public stereotypes about people who use needles, it’s been a fairly stigmatized way of contracting the disease.
But as with any stigmatization, the people on the receiving end of society’s judgment rarely benefit. According to the Center for Disease Control, HIV infection rates resulting directly or indirectly from injection drug use make up approximately 36% of known cases, and accounted for 28% of all new cases last year.
For women and children the rates are even higher. It is estimated by the Center for AIDS Prevention Studies 64% of all women contract the disease from either using needles or having a sexual partner who does. They also estimate that injection drug use is the source of over 50% of infections in children.
In the United States there are roughly 2.4 million injection drug users. That is 2.4 million people who are at a high risk for contracting and transmitting the HIV virus to other users, to their sexual partners, and their children. Not just the partners of users either, the partners of people who’ve been partners with users, and on and on, in a scary pay-it-forward web.
The virus is spread by the ultra-risky practice of sharing needles. This is the single most efficient way to transmit the disease and is really best avoided. People choose to share needles for various reasons, the most obvious being lack of access to new ones. Ten US states outlaw the purchase of syringes without a prescription. I doubt you need me to tell you that telling a doctor you need needles to shoot up is unlikely to get you a prescription. Without easy access to sterile needles, people are stuck re-using, sharing, or going through dealers to get their gear. All those methods are risky and are more likely to transmit disease than to get people off drugs.
There are several strategies for preventing the spread of the disease among injection drug users (IDUs). The first choice is to prevent people from starting injecting drugs. For those that already use it is important to do outreach to the most at risk group, people living on the streets and survival sex workers. Access to high quality rehabilitation and treatment is also vital.
For people who cannot or will not stop injecting drugs, access to harm-reduction techniques such as education on proper use of needles and access to clean unused needles most effectively prevent transmission of the virus.
Access to clean needles is a controversial issue in our society and thus I am going to use extra-special care to present the results of scientific research done on needle exchange programs (NEPs).
Needle exchange programs are born out of the harm reduction model of addressing drug use. Harm reduction relies on several principles. First, licit and illicit drug use has been and always will be a part of our society. It recognizes that drug use is a spectrum of behavior from total abstinence to severe abuse, and that some ways of using drugs are clearly safer than others. It also works to reduce individual and community harm, rather than demand a person totally quite using drugs. Its main objective is to reduce the risks associated with drug use rather than condemn or ignore them.
Needle exchange programs, like the one in Whatcom County, are usually part of the county health departments, since there is a ban on using federal funds for the operation of the facilities. They operate on a one-for-one rate where for every used, contaminated needle clients of the exchange get one clean, sterile one. Other resources typically include condoms, free or discounted HIV testing, syringe disposal, and of course they help their clients get into drug treatment.
So do they work?
Studies in the US and abroad have shown that well actually, yes they do. Medical research institutes, noted researchers, and a former Secretary of Health and Human Services have all found that NEPs reduce HIV transmission amongst IDUs. As an example of their effectiveness in Southern Australia, where there are 55 NEPs serving 1.2 million users, they have reported zero new HIV cases in three years.
So I realize this is a darker tone and topic than we’ve gotten used to, but ignoring this problem only makes it worse. If you want information about the Whatcom Needle Exchange, come talk to me, or use their facilities Mondays from 1 to 4, Thursdays from 6 to 8. They are located at 1500 N. State St, in the Health Dept. Building. Also, get tested. This Tuesday in VU 460 from 11 to 3 you can get tested for free. This is the single best thing you can do for yourself and your partners.
Stay safe Western.