Just what is harm reduction anyway?
It’s a strategy to keep people who engage in risk behaviors as safe as possible from HIV, hepatitis, overdose and other dangers. Clean syringes and injection kits for intravenous drug users, rubber pipe mouth piece for heroin or crack smokers and condoms are all forms of harm reduction offered at CitiWide. Harm reduction believes that drug users don’t deserve to get HIV and hepatitis even if some people don’t approve of their behavior. Harm reduction also reduces the spread of HIV and hepatitis in the broader community.
Does syringe exchange lead to more drug use?
Syringe-exchange opponents often claim this, but actually, a series of federally-funded reports have not found this—and most of the reports recommended that the U.S. ban on federal funding of syringe exchange be lifted.1 Late last year, it finally was. Moreover, research has found that needle exchanges often are a valuable first point of contact for drug users coming in off the streets.2 Often, it is the place where they connect not only to clean syringes but to services for health care, mental wellness and drug recovery.
Do clean syringes help reduce the spread of HIV and hepatitis?
Absolutely. A fifth of all HIV infections and up to 90 percent of hepatitis C infections are from sharing needles.3 Yet a 2003 study of 99 cities around the world found that cities with syringe exchanges saw HIV rates go down 19 percent a year. Cities without exchanges saw HIV rates go up 8 percent annually.4 A 2008 study found hepatitis C rates of 90 percent among injection-drug users before New York City instituted large-scale syringe exchange. Hepatitis C rates among those who started injecting after large-scale exchange were down to 56 percent.5 Still, hepatitis C is easier than HIV to transmit through injection drug use because it can be passed not just through syringes but the swabs, spoons and water used to inject. That is why CitiWide Harm Reduction provides entire cleaninjection “kits.” Finally, syringe exchange is cost effective: HIV treatment costs roughly $40,000 a year, while a clean syringe costs ten cents.
Syringe Exchange: A History
1. Shalala, DE. Needle Exchange Programs in America: Review of Published Studies and Ongoing Research. February 18, 1997; Des Jarlais DC, et al; Continuity and change within an HIV epidemic: injecting drug users in New York City, 1984-1992. JAMA 1994; 271:121-127.
2. Vlahov D, Junge B. The role of needle exchange programs in HIV prevention. Public Health Reports 1998;113(Suppl 1):75-80.
3. Glynn M, Rhodes P. Estimated HIV prevalence in the United States at the end of 2003. 2005 National HIV Prevention Conference; June 12–15, 2005. Atlanta, GA. Abstract T1-B1101.; Centers for Disease Control and Prevention (CDC). Hepatitis C fact sheet. Accessed December 22, 2005 from http://www.cdc.gov/ncidod/diseases/hepatitis/c/fact.htm.
4. MacDonald, M., et al. Effectiveness of needle and syringe programmes for preventing HIV transmission. The International Journal of Drug Policy, 2003.
5. Des Jarlais, D. Reducing HIV and HCV Transmission among Injecting Drug Users in New York, Presentation May 10, 2008, International Harm Reduction Conference.
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