Source: Milwaukee Journal Sentinel (WI)
Contact:  (414) 224-8280
Pubdate: Mon, 30 Mar 1998
Author: Marilynn Marchione of the Journal Sentinel staff


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

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

"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.