Pubdate: Sat, 10 Jun 2000
Source: Border Mail, The (Australia)
Author: Campbell Aitken


IN her letter to The Border Mail (May 31), Julianne Whyte made some
poorly-argued assertions about needle and syringe programs (also called
NSPs) which require refutation.

Ms Whyte claimed that programs have not shown any benefit in terms of
reducing HIV infections in Australia, but she skirted around the fact that
the vast majority of HIV infections in Australia, as in most western
countries, have been diagnosed in men who have sex with men - not drug

As a result of the introduction of harm reduction strategies (including the
promotion of safe sex messages and freer availability of condoms) HIV
incidence in gay Australian men, and therefore overall incidence, has

Australia differs from many other western nations by also having extremely
low rates of HIV among people who inject drugs (less than 2 per cent

In many parts of the U.S., where needle programs were introduced much later
than in Australia and are still relatively rare, 50 per cent of injecting
drug users now have HIV.

It is difficult to interpret this fact in any way other than that the early
introduction of needle programs saved Australia from experiencing a very
costly epidemic of HIV among drug users.

With regard to hepatitis C, it is certainly true that this virus is more
difficult to control than HIV because it has been around longer, is more
infectious, and is presently at much higher prevalence among drug injectors.

Nevertheless, the National Centre for HIV Epidemiology and Clinical Research
(Ms Whyte's own source) recently published research showing a significant
decline in exposure to this virus among drug injectors, (cited from the
Medical Journal of Australia, 2000, Vol 172).

Again, there is little reason to believe that anything other than the
availability of clean needles and syringes in Australia is reducing
hepatitis C incidence.

Needle programs are an important part of Australia's HIV and hepatitis C
prevention strategies.

These strategies should be recognised in this country, as they are overseas,
for what they really are - a public health triumph.

Dr Campbell Aitken, The Macfarlane Burnet Centre for Medical Research,
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