One of the most efficient ways for the AIDS virus to...

February 09, 1994

One of the most efficient ways for the AIDS virus to spread is through contaminated needles shared by people who inject drugs intravenously. AIDS' spread among intravenous drug injectors worries health officials because these drug users and their sexual partners represent the main conduit of HIV into the general heterosexual population.

Efforts to prevent the spread of of AIDS among IV drug users are thus an urgent priority in cities like Baltimore, with its estimated population of 30,000 heroin addicts. That is why the city is seeking a special exemption from the legislature this session that would allow health officials to give clean needles to addicts so they would not have to share drug paraphernalia and thus risk infection. State law currently prohibits possessing hypodermic syringes without a doctor's prescription.

Baltimore City's proposal is sure to spark controversy. Critics of the plan argue that by providing sterile needles the city sends a signal implicitly condoning illegal drug use. Police and law-enforcement officials fear the plan will further undermine the war on drugs and encourage more people to experiment with narcotics in the mistaken belief that IV drug abuse is "safe" again.

Such concerns suggest it may be useful to study examples of cities that have tried various needle-exchange plans. A survey of needle-exchange programs in half a dozen cities around the world in the current issue of Scientific American magazine suggests that while such programs cannot halt the AIDS epidemic once it becomes entrenched in an IV drug-using population, they can significantly slow the increase in the rate of new infections.

More than a decade into the epidemic, the majority of new AIDS cases in the Baltimore region is occurring not among gay men but among IV drug abusers and their sexual partners. Yet the Scientific American survey suggests that, contrary to many stereotypes, IV drug users are not oblivious to the threat posed by AIDS, and they can be taught to alter their behavior in ways that reduce their risk of infection. Even the best designed programs, however, cannot succeed unless there is the political will to make them work.

There's no magic bullet to end the AIDS menace. But there are steps government can take to save thousands of lives. Needle-exchange programs admittedly represent a partial sanctioning of a lesser evil -- illegal drug abuse -- over the uncontrolled spread of AIDS. They are nevertheless an alternative lawmakers ought to approve.

AIDS and the IV drug abuser

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