California: Needle Exchange Ban Could Be Lifted

If approved, legislation winding through Congress that authorizes federal funding of syringe-exchange programs could eventually help local SEPs. In San Francisco, SEPs have been credited with keeping HIV incidence down among injection drug users (IDUs).

"If the federal ban is lifted, it gives jurisdictions much more flexibility in terms of how to spend federal dollars," and other funding, said Dr. Grant Colfax, the city's HIV prevention director. "Ultimately, the best thing would be for the federal government to really invest" in the intervention, "which we know is effective and saves lives," he said.

In 2008, 10 percent of the city's 434 new HIV diagnoses were in men who had sex with male IDUs, and there were 74 new diagnoses among IDUs, said Dr. Susan Scheer, co-director of the city's HIV epidemiology department. In 2006, San Francisco IDUs contracted an estimated 144 new HIV infections, including cases not diagnosed or reported, according to the health department.

This year, San Francisco provided $881,463 to three agencies doing mostly SEP work, as well as to a couple of others that provide syringe access among other services.

Each week, Tenderloin Health exchanges 2,645 syringes for 109 clients and offers them alcohol pads and sterile water. The agency, based in one of the city's poorest neighborhoods, also provides HIV testing and one-on-one harm reduction counseling. Tenderloin Health received $68,945 from the city and $12,500 annually from the Syringe Access Fund, a joint project of several sponsoring foundations.

The San Francisco AIDS Foundation served 12,000 IDUs from 11 SEP sites in fiscal year 2008-09, said CEO Mark Cloutier. The sites also offer clients HIV testing, hepatitis B vaccination, wound care and addiction treatment referrals. Due to increased demand, city funding for SFAF's SEP ran short two months before the last fiscal year ended, but SFAF was able to secure needed funding and contributions, Cloutier said.

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