amfAR, The Foundation for AIDS Research

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Why Congress Should Rethink Syringe Issue

By Kevin Robert Frost

Published Friday, April 17, 2015 on

If someone told you that your city had started a program providing clean needles to injecting drug users, would that make you want to start injecting drugs yourself? The answer, of course, would be no. Yet for decades, many have stood by the belief that such programs, known as syringe exchange or syringe services programs, promote and encourage drug use. Indeed, for Congress, it became the rationale behind a ban implemented in 1988 that prohibits the use of federal funds for these programs.

But an overwhelming body of scientific evidence continues to show that this is simply not true.

As a result of the recent spikes in HIV and hepatitis C infections among injecting drug users in rural Indiana and Kentucky, the controversial topic of syringe exchange programs has come to the fore again. And this time, scientific evidence and sound public health practices prevailed as both states authorized the implementation of syringe exchange programs to help curb the spread of these two blood-borne diseases that can be spread by contaminated syringes.

This is a welcome step -- an estimated 50,000 Americans are newly infected with HIV every year, and some 8% are among injection drug users. Meanwhile, between 2006 and 2012, at least 30 states experienced increases in hepatitis C infection rates, with more than half reporting at least a 200% increase in acute infections among young adults. Overall, the prevalence of acute hepatitis C among people under 30 rose from 36% to 49% in six years.

With such numbers in mind, the recent national spotlight on syringe services programs offers a critical opportunity for us to reignite a much-needed conversation.

Dozens of studies have demonstrated conclusively how effective syringe services programs have been in the fight against HIV and hepatitis C transmission among injection drug users by reducing the reuse and sharing of dirty syringes -- without increasing drug use. In addition to helping curb the spread of these diseases by offering access to sterile syringes, these programs promote public health and safety by taking syringes off the streets and protecting law enforcement personnel and others, including children, from injuries. They also offer preventive health services, such as HIV testing and counseling, and form vital bridges to drug treatment, overdose prevention, housing and employment services.

For states such as New York and Washington -- early adopters of these interventions -- syringe services programs have played a crucial role in driving down HIV transmission among injecting drug users.