EDUCATION & OUTREACH
At Missouri Safe Project, we are dedicated to stepping up our efforts in addressing this issue. This is by no means an easy feat, but through cooperation and community empowerment we believe we can facilitate progress in this area. We are always striving to make a difference, and invite you to learn more and lend your support.
1. Does needle exchange reduce the number of HIV infections?
Mounting epidemiologic data point to an overall decline in new HIV infections among injection drug users (IDUs) over the past 20 years in the United States, with parallel but more modest decline in hepatitis C rates. Newly revised HIV incidence estimates from the CDC projected that in 2006, injection drug use accounted for 6,600 HIV infections in the U.S., with an additional 2,100 new infections among men who have sex with men (MSM) who also report injecting drugs. The authors note: “Overall, HIV incidence among individuals exposed through IDU has decreased approximately 80% in the United States. Over that time, (people) exposed through IDU have reduced needle sharing by using sterile syringe available through needle exchange programs or pharmacies and have reduced the number of individuals with whom they share needles.” Similar declines in hepatitis C prevalence among IDUs, though lesser in magnitude, have been reported in several cities with syringe access programs.
2. Does syringe access increase drug use?
No. Many scientific studies, including a Surgeon General’s report, show that needle exchange does not increase drug use when conducted with referrals to both drug treatment and HIV and Hepatitis C testing, medical care and support services.
3. How can syringe access help a community?
Syringe access services are about public safety. Not only do they prevent the transmission of HIV and other blood borne pathogens to people who use injection drugs, but they also protect the community at large by preventing infections among their sexual partners and children. Most UCHAPS (Urban Coalition for HIV/ AIDS Prevention Services) jurisdictions have successfully developed syringe access services utilizing local and state funds while protecting public safety. Each local health jurisdiction has developed the services with an understanding of their urban landscapes and their communities’ needs in order to save money by preventing costly-to-treat infections and, more importantly, to save lives.
4. Harm reduction programs have been shown to lower HIV risk and hepatitis transmission, prevent overdose, and provide a gateway to drug treat- ment programs for drug users by offering information and assistance in a non-judgmental manner. Harm reduction also protects law enforcement officers from needlestick injuries—accidental pricks to the skin from handling hypodermic needles. By providing safe disposal of injection equipment, harm reduction programs reduce the number of contaminated syringes circulating in a community. (Credit to North Carolina Harm Reduction Coalition.
IMPORTANT PRINCIPLES OF HARM REDUCTION PROGRAMS INCLUDE:
A non-judgmental approach that treats every person with dignity, compassion, and respect, regardless of circumstance or condition.
Utilizing evidence-based, feasible, and cost-effective practices to prevent and reduce harm;
Accepting behavior change as an incremental process in which individuals engage in self-discovery and transition through “stages of change;”
Active and meaningful participation of drug users, former drug users, and community stakeholders in shaping sensible policies and practices around drug use;
Focusing on enhancing quality of life for individuals and communities, rather than promoting cessation of all drug use;
Recognizing complex social factors that influence vulnerability to drug use and drug-related harm, including poverty, social inequality, discrimination, and trauma;
Empowering drug users to be the primary agents in reducing the harms of their drug use;
Commitment to defending universal human rights.
HARM REDUCTION ENCOMPASSES A BROAD RANGE OF ACTIVITIES AND INTERVENTIONS DESIGNED TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF INDIVIDUALS AND COMMUNITIES. THESE INCLUDE:
Outreach and peer education to reduce risks associated with drug use;
Needle and syringe exchange programs (SEPs);
Opioid substitution therapies (OST) for drug dependence, including methadone and buprenorphine;
Confidential counseling and testing for HIV, hepatitis, and other sexually transmitted or bloodborne infections;
Overdose prevention activities, including Naloxone (a prescription drug to prevent overdose) and first aid training;
Provision of primary care and treatment for HIV and other sexually transmitted or blood-borne infections;
Referrals to drug treatment programs.
Syringe access programs are intended to prevent the spread of the HIV virus and other blood-borne diseases, such as hepatitis B and C, among injection drug users and their sexual partners. Equally important as the actual exchange of syringes is the opportunity for outreach workers to provide participants with updated information and referrals regarding medical and social services in the community related to both drug treatment and HIV medical care and support services.
Access to sterile syringes spares lives and saves taxpayer money: The Institute of Medicine has concluded that: "the cost-effectiveness of needle exchange is estimated to range from $3,000 to $50,000 per HIV infection prevented." The cost of a sterile syringe can be as little as 97 cents. Centers for Disease Control and Prevention, Syringe Exchange Programs 2005
Syringe access programs lower health care costs: The estimated lifetime cost of treating an HIV positive person is between $385,200 and $618,900. Schackman BR., Gebo KA., Walensky RP et al., "The Lifetime Cost of Current Human Immunodeficiency Virus Care in the United States." Medical Care, November 2006, 44(11); 990-997