Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #118815

Allan Clear, Harm Reduction Coalition, 22 W 27th St, 5th Floor, New York City, NY 10001, 212-213-6376, clear@harmreduction.org

Syringe exchange has been a consistent presence on the public health landscape in the US since 1986 when it was discussed in New York City as a means of stemming the spread of HIV. In 2005, Congress held hearings to decry the immorality of providing syringes to injection drug users and the Federal government attempted to force United Nations Office on Drugs and Crime to back away from supporting the intervention.

Despite a consistent 1988 federal ban on the funding of syringe exchange, programs developed rapidly from the late 1980s until the mid 1990s as a result of direct action on the part of activists and community. Counterintuitively growth slowed through the 2000s as health departments embraced the intervention.

Research reveals that programs in New York City have reduced HIV prevalence among injectors from 50% to 15%. In 2003 there were 760 new AIDS diagnoses among injectors compared with 5,895 in 1993. Despite solid evidence that syringe exchange is the most effective HIV prevention intervention available to drug injectors, and despite evidence that disenfranchised, disconnected injectors have their health immeasurably improved by direct service and through referrals to other needed services, and despite recognition by the NIH, NIDA, and numerous national governments that syringe exchange is effective and necessary, elected officials in the US maintain that providing sterile syringes to injectors not only does not work but that it sends the wrong message to society.

Learning Objectives: Attendees will be able to

• Describe the history of needle exchanges programs to date in the United States.
• Identify three barriers to federal adaptation of the method
• Evaluate the shortcomings of evidence-based public health in the face of ideology and politics

Keywords: Politics, Substance Abuse

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation