NEEDLE EXCHANGE PROGRAMS

HELP STOP HIV TRANSMISSION

The transmission of HIV through unscreened transfusions or blood products has declined, but such transmission still can occur (see cards 51 and 60). Today, most blood-borne HIV is passed along through the sharing of intravenous (IV) hypodermic needles. Scientists do not agree on how long HIV can remain infectious inside a syringe. Some believe the danger period is as short as five minutes, while others contend it can be longer than a day.

Health officials, recognizing that trying to stop all IV drug use is futile, say that for those who do shoot drugs, the best precaution against HIV is to not share needles. Next best, they note, is regular use of a chlorine disinfectant to kill the virus. That disinfectant is nothing more than a solution of simple liquid household bleach, used to rinse the syringe and clean the needle between uses.

Needle exchange programs-in which drug users return used needles for free clean ones-have met with protests from those who say such programs condone illegal drug use. Still, needle exchanges have proved successful in such diverse places as New Haven, Connecticut; Portland, Oregon; Seattle, Washington; New York City; and Boulder, Colorado. In the New Haven project, which

was run along strictly experimental lines, researchers using numbercoded needles reported a 1/3 drop in new HIV infections within eight months. They also found that the average time a needle stayed in circulation fell to 1/3 of the usual 21/2 weeks it would normally be in use, with a dramatic drop in the number of needles that came back HIV-positive (67.5% to 40%). Such results have led other cities to consider lifting their bans on needle exchange programs.

Next Card 69: SHOULD YOU GET TESTED?: What the HIV Test Will Tell You

STOPPING BLOOD TRANSMISSION