The Fresno County, Calif., Board of Supervisors should follow the recommendations of the county's grand jury to implement a needle-exchange program to prevent the transmission of bloodborne diseases, including HIV and hepatitis C, a Fresno Bee editorial says (Fresno Bee, 7/13). The grand jury in an interim report released late last month recommended that Fresno establish a needle exchange. Although the county previously has considered such programs, it has not implemented them for various reasons, including liability concerns. However, under a state law (AB 136) passed in 1999, California counties and their agents are protected from criminal prosecution for operating needle-exchange programs. The grand jury report said the supervisors should enact a needle-exchange program using AB 136 and another state law (SB 1159) that allows cities and counties to authorize pharmacies to sell up to 10 sterile syringes at one time to an adult without a prescription. The grand jury in its report cited a study published in the September 2004 issue of the Journal of Urban Health that found the county had 173 injection drug users for every 10,000 residents, the highest ratio of any U.S. metropolitan area (Kaiser Daily HIV/AIDS Report, 7/12). Needle exchanges would save the county money because it costs about $200,000 to treat an HIV-positive individual, compared with $1 for a syringe, and also might encourage some injection drug users to seek drug treatment, the editorial says. The state Legislature has "sent clear signals" to the Board of Supervisors that establishing a needle-exchange program is "good preventative health policy," and it should follow the grand jury's advice to set up the programs, the editorial says (Fresno Bee, 7/13).

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