The controversy over needle exchange programs is nothing new. It’s been debated for decades. What’s new is the CDC’s latest report that shows a change in trends.
According to the recent report, new HIV infection numbers are growing and we don’t have enough syringe programs to fight them. Specifically, needle-sharing by opiate addicts has put rural white communities “at much greater risk of new HIV infections than ever before.” In fact, the opiate crisis has had such an impact on these communities that whites who inject drugs now have more HIV diagnoses than any other racial population – for the first time ever.
Current Program Reach Falls Short
The CDC found that the use of syringe programs has increased over the past decade, however it’s clearly not enough. The CDC points out that programs aren’t located in the areas that need them the most. Using National HIV Surveillance System data, the CDC analyzed trends in HIV diagnoses.
“There’s a striking mismatch,” said John Brooks, a senior medical adviser at CDC’s Division of HIV/AIDS Prevention. Their vulnerability assessment “demonstrates what parts of the country we’re very concerned could have an event like Scott County.” (This Indiana county of just 24,000 people saw 200 diagnoses of HIV infection in 2015 alone. It was the worst outbreak in state history.)
More than 40 percent of state counties in Kentucky, Tennessee and West Virginia are considered “vulnerable to rapid spread of HIV and new or continuing high numbers of hepatitis C infections among injection drug users.” Yet, syringe programs in these states are few and far between.
Nationwide, only 17 states and Washington D.C. authorize needle exchange programs. According to the North American Syringe Exchange Network, there are a total of 228 syringe service programs across the states, Puerto Rico and Native American lands.
Are Syringe Programs Effective?
The CDC points out that needle exchanges provide several services to the community. Namely, they provide sterile needles and syringes, disease testing for HIV and hepatitis C, and assistance for patients to get counseling and further treatment.
Previous CDC studies have shown that needle exchange programs are effective in reducing HIV transmission rates and lowering the risk of hepatitis infections among drug users. Specifically, the CDC’s most recent report claims, “Access to comprehensive prevention services is essential for all people who inject drugs. Syringe services programs reduce syringe sharing and can help people who inject drugs access prevention and treatment services for HIV and other blood-borne diseases, such as hepatitis C and hepatitis B.”
This CDC’s report indicates the opioid epidemic is reversing progress previously made in reducing HIV spread by dirty needles. And the risk is spreading to new communities.
CDC Director Tom Frieden said, “The big picture here is that we’ve had a lot of progress reducing HIV infections spread by needles and we’re at risk of stalling or reversing that progress. More people appear to be injecting drugs, more people are sharing needles, and there are more places not covered by syringe service programs.”
After banning the use of federal funds for syringe programs in 2011, Congress reconsidered in 2015 – after the HIV outbreak in Scott County, IN opened eyes to the rising rates of injection drug use in our nation. At that time, Congress changed the restriction. Now funds can be used for parts of the program (other than paying for sterile syringes) if there is an HIV or hepatitis outbreak risk.
So far, the CDC has approved requests from 15 states and counties asking for federal HIV funds to be used for syringe programs. It’s a start…
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