Needle Exchange Credited with Reducing HIV in Rhode Island Drug Users

Paul Loberti, chief administrator of the Rhode Island Health Department's Office of HIV & AIDS, reported last week that an effort to get clean needles to drug addicts seems to have slowed the transmission of HIV among people who inject illegal drugs. "In 1993, we were looking at over 50 percent of the cases [of HIV infection] due to injecting drug use. Today it's one-third," Loberti said.

He credits Rhode Island's needle exchange program, which started in 1994 with a staff of volunteers in a donated storefront. Since then, the program has dispensed more than 120,000 clean needles to more than 17,000 addicts, Loberti said. Other programs have helped, including one that gave addicts prescriptions for syringes. Last year, syringes were legalized in Rhode Island; now, anyone can buy one at a drugstore.

Although he said the data do not yet meet the standards of scientific evidence, Loberti sees strong indications that HIV transmission among intravenous drug users is declining. His evidence is based on the results of the HIV tests the state offers. But two years ago, the state changed the way it collects that data, so he cannot make exact comparisons over the years. Prisoners are required to be tested for HIV, and in 1990, 51 percent of all HIV tests at prisons were HIV-positive. In 2000, 17 percent of prisoners were HIV-positive. Most prisoners with HIV contracted it through intravenous drug use.

AIDS figures are more solid, since doctors are required to report every diagnosed case, and have experts worried about youth. Fifteen percent of AIDS cases diagnosed in Rhode Island last year were in people ages 20 to 29. Young adults ages 15 to 24 represent 71 percent of all the STD cases reported in the state last year. Loberti said that more young people are testing positive for HIV because more are taking the test. "I don't think a lot has changed in terms of behaviors," he said. "Knowledge and awareness levels are very high in youth. They know how they can get it and how they can prevent it," Loberti said. But knowledge does not always translate into action.

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