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Policy Watch: SFAF Leads Efforts to Reduce HIV Infections Among Injection Drug Users

November 2001

There is undeniable proof that measures that allow injection drug users (IDUs) to obtain sterile syringes -- rather than resorting to the sharing of needles -- significantly reduce the transmission of HIV, hepatitis B and C and other blood-borne diseases. And yet nothing points out the counterproductive nature of our nation's and state's drug policy more glaringly than our limited efforts to prevent disease transmission among IDUs.

Two approaches have been taken in various parts of the country to assure that IDUs have access to sterile syringes. As of 1998, needle exchange programs were operating in at least thirty-one states. These programs permit IDUs to exchange used syringes for clean ones, helping to assure not only that HIV transmission is reduced, but that dirty needles are safely disposed of in order to prevent needlestick injuries to others.

California passed a law in 1999 that specifically allows local jurisdictions to declare a local health emergency and legalize needle exchange programs. Authored by Assemblywoman Kerry Mazzoni (D-Novato), this law went into effect in January of 2000. Twelve California counties, including San Francisco, have taken advantage of the law and have legalized needle exchange programs in their jurisdictions.

A second approach is to allow individuals to purchase syringes from pharmacies without a prescription. Forty-four states currently permit individuals to do this. Unfortunately, California remains one of only six states in the nation that does not permit adults to purchase syringes at a pharmacy. In addition, drug paraphernalia laws in California still make it illegal for IDUs to possess syringes even if they have obtained them through an exchange program for the purpose of preventing HIV transmission.

Some elected officials oppose efforts to provide clean needles to IDUs, arguing that they encourage drug use and increase crime. Numerous studies of needle exchange programs, however, show that these programs are successful at sharply reducing HIV transmission rates among IDUs and that they do not increase drug use. In fact, needle exchange programs have been shown to serve as a bridge for many IDUs to enter drug treatment programs.

Not only are conservative arguments about syringe access contradicted by the facts, they mask a troubling lack of compassion for drug users and their sexual partners and children. These arguments also ignore the fact that ten cents spent on a sterile syringe can save a life while the cost of treating a case of HIV infection can run well over $100,000. Sadly, ideological opposition to expanded syringe access for IDUs is so strong that, despite concluding that needle exchange programs save lives and do not promote drug use, the federal Department of Health and Human Services refuses to provide any federal financial support to these programs.

Efforts are now underway to ensure broader access to sterile syringes in California. The San Francisco AIDS Foundation is one of the key organizations working with Assemblywoman Dion Aroner (D-Berkeley) to secure passage of AB 1292, the Pharmacy Syringe Access and Disease Prevention Act. If it becomes law, this bill will permit adult Californians to purchase syringes without a prescription at a pharmacy and eliminate paraphernalia laws that make it illegal to possess a syringe. AB 1292 would also encourage the safe disposal of used syringes as a means of further preventing the transmission of blood-borne diseases.

Unfortunately, AB 1292 faces a difficult time in the State Legislature because many legislators fear that voting for such a bill will make them appear "soft on crime." Public pressure in support of the bill is therefore essential. Hearings on the bill in the Assembly Health Committee are expected in January. Outreach readers who want to join in the effort to support this measure are encouraged to contact the Public Policy Department at 415-487-3080 or

Back to the SFAF OUTReach November 2001 contents page.

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This article was provided by San Francisco AIDS Foundation. It is a part of the publication OUTReach. Visit San Francisco AIDS Foundation's Web site to find out more about their activities, publications and services.
See Also
Ask Our Expert, David Fawcett, Ph.D., L.C.S.W., About Substance Use and HIV
Needle Exchange & HIV/AIDS: California
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