A city managerial task force on AIDS and hepatitis C has found the rate of HIV infection and hepatitis C in Worcester, Mass., alarmingly high. Worcester has the second-highest AIDS rate in Massachusetts, twice the state average. Holyoke leads the category with three times the state average.

According to the interim report, the majority of people at risk for HIV are intravenous drug users and their sexual partners. The task force believes a clean needle exchange program -- which city officials have been loath to adopt -- would make a dent in infection rates. "Education and prevention services should, ideally, be placed in combination with an access to clean syringes program. The rate of transmission of infection among IDUs through shared needle use could be reduced by clean needle exchange programs based in pharmacies, doctors' offices, and/or community health settings. The rate of transmission could also be reduced by changes in the law pertaining to possession of needles and/or syringes," the report said. Other findings include:

• Minorities make up more than half of those with or at risk for HIV.

• Hepatitis C rates and prevalence are unknown; more testing and education are needed.

• Most Worcester residents seeking substance abuse treatment are heroin users, half of whom are also addicted to cocaine or crack cocaine. Arrests for possession of syringes were up over the last five years.

• The city provides adequate education about HIV and hepatitis C, but an increase of outreach and collaboration are needed.

• Public and private schools should adopt a more factual and detailed education program regarding transmission and prevention of HIV and hepatitis C.

• Family-centered, community-based education programs are needed.

• Programs should be available to raise health care workers' awareness of the infections.

The task force said the city could play a leading role in enacting these reforms. The HIV, AIDS and Hepatitis C Task Force is headed by AIDS researcher Dr. John Sullivan of the University of Massachusetts Medical Center.

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