It is well understood that by distributing free condoms and lubrication, health educators are helping to stop the spread of HIV, not encouraging sex. The same logic can be applied to Syringe Exchange Programs (SEP). Syringe Exchange Programs operate on the rationale that injection drug users (IDUs) will do anything for a hit, including sharing dirty needles. If clean needles were easily accessible, IDUs would use them to protect themselves. However, since injection drug use is an illegal activity, there are few places that an IDU can obtain clean needles. Providing an exchange program where IDUs can exchange their dirty needles for clean ones provides critical points of interception. In addition to disposing dirty needles and providing access to clean needles to stop the spread of HIV, SEPs provide a unique opportunity to engage with IDUs and direct them to resources for drug treatment. These intervention points would not be possible without SEPs.
The issue: Legal, Moral, and Political
Despite mountains of evidence that show that needle exchange programs stem HIV incidence, Riverside County has failed to approve a syringe exchange program. The failure of the Board of Supervisors to approve an SEP is particularly irresponsible when one considers the rate of HIV incidence consistently seen at D.A.P. test sites is three times the national average. The reasons for the failure to allow an SEP is three fold – legal, political, and moral. To some, providing clean needles to IDU is an endorsement of an illegal activity. However, this is not the case.
Others consider syringe exchange programs morally wrong, based on the notion that heath educators facilitate further drug use when they provide clean needles. However, rather than encourage further drug use or endorse illegal activity, SEPs work towards harm reduction. They ensure safest possible outcomes of injection use – both to the user themselves and to the general public. Syringe exchanges increase public safety by ensuring that dirty needles are properly disposed – protecting children and sanitation workers from getting stuck with tainted needles. SEPs are also part of larger public health initiatives to combat HIV infection among injection drug users, spouses, partners, and others.
Politically, SEPs are a hot button issue. Although city and local officials may understand the rationale and importance of the program, there is often backlash from voters, community members, and other constituents who only consider legal and moral issues with providing clean needles to drug users.
What can I do?
Lobby your city and other local officials and tell them how important a Syringe Exchange Program is to combat HIV, Hepatitis C, and other infections. Write letters, attend meetings, call, and gather strong support for the issue. Organize and encourage others to do the same. The more grassroots support we can build, the more difficult it becomes for the Board of Supervisors to reject the program.