Source: San Francisco Chronicle (CA) Contact: http://www.sfgate.com/chronicle/ Pubdate: Wed, 19 Aug 1998 Author: David Perlman, Chronicle Science Editor Section: Page A9 NEEDLE EXCHANGE PROGRAMS PROLIFERATE 17.5 million syringes distributed last year despite funds ban Despite a congressional ban on federal funds for needle exchanges to prevent the spread of AIDS, the programs are broadening their activities and spreading swiftly across more than 30 states, the government's Centers for Disease Control and Prevention reported yesterday. Financed by ingenious combinations of local government funds and private donations, the programs distributed more than 17.5 million syringes to injection drug users last year alone -- whether the operations were legal under state or local laws or were operated entirely underground, the agency said. Because federal health chief Donna Shalala has refused to lift the ban on funding imposed by Congress 10 years ago, the CDC report was circumspect and did not explicitly declare that needle exchanges have proved successful in the battle against HIV disease. But it did point to other recently published research reports that say exactly that. Wherever they operate, according to the reports cited by the agency, needle exchange programs have notably slowed the spread of HIV infections. The programs provide instruction in the use of condoms and other safer-sex measures, refer thousands of injection drug users to drug abuse treatment programs and often offer on-site health care to addicts. The needle exchange program operated by the San Francisco AIDS Foundation was by far the most active one in the country, distributing 1.2 million syringes last year alone, the CDC reported. But even that figure is an underestimate and out of date, according to Pat Christen, the foundation's executive director. By now, she said yesterday, the San Francisco program is exchanging clean syringes for contaminated ones at the rate of 2.4 million a year, with the strong support of Dr. Mitchell Katz, the city's public health director. ``Needle exchange programs are quite effective in slowing the spread of HIV,'' Christen said, ``even though the administration persists in its absurd position that prevents federal financing for them.'' The CDC figures, published in the current issue of its Morbidity and Mortality Weekly Report, indicate that 113 syringe exchange programs were active in the United States last year and 100 were reporting to the CDC in detail. Two years ago, there were 84, and two years before that, 55. The federal agency's report noted that the needle exchange programs are successfully reaching people who are at risk for many blood-borne infections, including HIV, the virus that causes AIDS, and hepatitis C, which currently afflicts some 4 million Americans and can lead to fatal liver disease. The programs also increase the number of drug abusers who use a syringe only once, thereby eliminating the re-use of potentially contaminated syringes, the agency said. Drug users who obtain their needles from the programs have lower rates of HIV infection than those who obtain needles on the black market or who share them with other users, according to the CDC analysis. 1998 San Francisco Chronicle - --- Checked-by: Mike Gogulski