Source: Milwaukee Journal Sentinel (WI) Contact: (414) 224-8280 Website: http://www.jsonline.com/ Pubdate: Mon, 30 Mar 1998 Author: Marilynn Marchione of the Journal Sentinel staff SURVEY SHOWS NEEDLE EXCHANGE SUPPORT Results seen as contrary to political reluctance to use tax money for programs Most Milwaukeeans support needle exchange programs to fight AIDS and think that tax revenue should help pay for them, according to a poll to be released today, a day before the ban on federal funding for such programs expires. The poll was done by the University of Wisconsin-Milwaukee's Institute for Survey and Policy Research and was paid for by the AIDS Resource Center of Wisconsin, an AIDS service agency that operates in most of the state, except the Madison area. It's the first local survey on the topic, and it echoes findings of at least two recent nationwide polls and scientific studies concluding that such programs don't encourage drug use but do stem AIDS. The UWM poll of city residents shows 57% approve of needle exchange programs, 36% oppose them, and 7% were undecided. The poll, conducted in December, was of 409 randomly selected adults, and the survey has a margin of error of 4.9 percentage points. Asked whether existing government AIDS prevention money should be used to fund needle exchange programs, 55% said yes, 40% said no, and 5% were undecided. "The people of Milwaukee are far ahead of the politicians on needle exchange," said Doug Nelson, executive director of the local AIDS agency. Nelson said the survey "takes away the excuse" that U.S. Health and Human Services Secretary Donna Shalala and Milwaukee Mayor John Norquist have used -- that the public doesn't support it -- to justify their opposition to allowing tax money to be used for needle exchange. Shalala is reassessing her position because the ban on using federal funds for such programs expires Tuesday. Nelson called on Norquist to do the same, and to allow some of the city's $340,000 annual grant to the AIDS agency for prevention programs to be shifted to needle exchange. Norquist's chief of staff, Bill Christofferson, said Sunday, "we'll certainly look at that," referring to the poll, but said results may have been skewed by the way the questions were asked -- "current government AIDS prevention dollars" rather than "property tax money," for instance. Norquist's position is that "providing free needles to drug users is not a use of property tax money that Milwaukee taxpayers would support," Christofferson said. HIV, the virus that causes AIDS, is spread when drug users share needles contaminated with blood. Using clean needles prevents the infection of other drug users, and the condoms and counseling dispensed by needle exchange programs prevents the spread of HIV through unprotected sex. More than 55 cities now have needle exchange programs. The first such program began nearly a decade ago in Tacoma, Wash. Numerous scientific studies have shown such programs reduce the spread of AIDS among drug users and to their partners and children and don't encourage new drug use. The American Medical Association, the American Public Health Association, the National Academy of Sciences, the American Bar Association, the U.S. Conference of Mayors and a host of other groups have endorsed needle exchange, Nelson said. Milwaukee's program started in March 1994, was expanded into Racine about two years ago, and has exchanged more than 1 million needle since it began. A $30,000 grant from the Milwaukee Foundation composed a large share of its $100,000 annual budget that year. Users must bring in dirty needles to obtain clean ones; it's a one-for-one exchange. Needles aren't exchanged with juveniles. Workers also offer HIV testing, drug counseling, and condoms to needle exchangers, and the program recently won national recognition for its success -- only 2% of participants are HIV-positive, Nelson said. But it only reaches about one-third of Milwaukee's estimated 4,000 to 5,000 intravenous drug users, he said. More could be reached if the program could use some of the $500,000 in federal prevention money and some of the city money the agency already gets, he said. Milwaukee Health Commissioner Paul Nannis, who will leave April 7 for a job in Washington, D.C., with Shalala's department, said Sunday, "This is an issue where science intersects with politics." Nannis noted the scientific support for needle exchange. For instance, a September 1995 report by the National Research Council and the Institute of Medicine concluded that needle exchange "remains the safest, most effective approach for limiting HIV transmission" among drug users who cannot or will not stop injecting drugs. Such programs do not increase either the amount of drugs used or the number of users, the report also found. In New Haven, Conn., researchers found a 33% drop in the rate of new HIV cases originating from dirty needles. A poll in December by the Kaiser Family Foundation, one of the largest private health foundations in the country, found that 64% of the public favors needle exchange programs and 61% think the current law should be changed to allow funding for them. Earlier this month, President Clinton's AIDS advisers demanded that the administration immediately allow local communities to spend federal money on needle exchange programs. The Presidential Advisory Council on HIV/AIDS said 33 people every day catch the AIDS virus directly from a dirty needle. "Lack of political will can no longer justify ignoring the science," the council wrote to Shalala. Congress in 1988 specifically prohibited federal funds for needle exchange programs, but it left ways for the policy to be reversed in the future.