American Academy of Pediatrics Policy Statement Says Pediatricians Should Advocate for Needle Exchanges

The American Academy of Pediatrics on Monday released a policy statement in the journal Pediatrics that says pediatricians should voice support for needle exchange programs to curb the spread of HIV among injection drug users, the AP/Houston Chronicle reports. The group's previous policy, which was adopted in 1994, said needle-exchange programs should be "encouraged and expanded." The new policy statement, titled "Reducing the Risk of HIV Infection Associated With Illicit Drug Use," says that physicians should discuss HIV prevention with adolescent patients "with a nonjudgmental approach" and offer confidential support if laws allow it. Congress has banned federal funding for needle-exchange programs, but 36 states and the District of Columbia have such programs, according to the North American Syringe Exchange Network (AP/Houston Chronicle, 2/5). The policy statement also says that:

• Pediatricians should assess "risk behaviors" related to HIV as part of every visit with patients;
  
• Doctors should consider the risks and benefits of prescribing antiretroviral drugs to adolescents who were exposed to HIV within 72 hours of their visit and accompany any postexposure prophylaxis treatment with "risk-reduction counseling and referral to appropriate substance-abuse treatment";
  
• Pediatricians should advocate for "seamless access" to reproductive health services for youths;
  
• Pediatricians should advocate for services such as mobile vans and drop-in clinics that aim to reach youths who might not regularly visit a physician;
  
• Parents should be given information about ways to talk about substance use and sexual activity; and
  
• Pediatricians should advocate for "youth-friendly" substance-abuse treatment facilities (Henry-Reid et al., Pediatrics, February 2006).
  

Reaction
"If we can help young people avoid a chronic illness that we have no cure for, I would hope people would embrace that idea," lead author Lisa Henry-Reid of John H. Stroger Jr. Hospital of Cook County in Chicago said in a statement. However, Concerned Women for America President Wendy Wright said recommending needle-exchange programs "will not rescue patients and neither does it promote healthy behavior" (AP/Houston Chronicle, 2/5).

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