Pubdate: 3 Mar 1999
Source: Standard-Times (MA)
Copyright: 1999 The Standard-Times
Contact:  http://www.s-t.com/
Author: Polly Saltonstall, Standard-Times staff writer

CITY'S ADDICTS CONTINUE RISKS

Drug war is one battle at a time

NEW BEDFORD -- A new study of local drug addicts using needles has
confirmed what outreach workers have long suspected: Nearly one-third
tested positive for HIV, while almost three-quarters denied being at risk.

A substantial majority, 64 percent, said they shared needles.

The study shows that despite a high rate of drug-related HIV/AIDS infection
in New Bedford, people who do not know they are infected continue to put
other people at risk, said Stewart Landers, a senior consultant at the
Boston-based firm, John Snow Inc., which conducted the survey for the
Department of Public Health.

"People might fear that they would find numbers like these but actually
seeing it in black and white will be upsetting," he said of the study,
which has just been released. "There's become a bit of complacency around
the epidemic and this is a stark reminder that it's not going away."

New medicines have extended the lives of those already infected with the
virus and lulled many drug users and others at high risk of contracting the
virus into a false sense of security, he said.

The rate of infection in New Bedford's needle users is high, said Dr. Jean
McGuire, director of the state Department of Public Health's HIV/AIDS Bureau.

She emphasized that the study focused only on needle users and did not
apply to the city's overall population.

Statewide, only about 2 percent of the people using the state's counseling
and testing service test positive, she said. About 10 percent of inmates in
jails and prison test positive for HIV.

Mr. Landers and Dr. McGuire both argued a needle exchange would benefit
addicts and help lower the rate of HIV transmission. City voters turned
down a needle exchange in 1996.

"One of the things this data should do is to promote a conversation in New
Bedford about the efforts currently under way and what other things need to
be undertaken or revisited, including the needle exchange," she said.

Lenny Spinner, co-chairman of the New Bedford AIDS Consortium, agreed.

"The city is in denial, denial, denial," he said. "If they don't wake up
and smell the coffee, we are going to be in serious trouble down the road
because this won't just go away. Fewer people are dying, but the same
number are getting infected. What will that do to our health-care delivery
system?"

Liz DiCarlo, a nurse with a master's degree in public health, worked for
more than two decades on drug treatment and outreach in New Bedford and
helped start the outreach organization Treatment on Demand. Recognizing the
difficulties of establishing a needle exchange, she faulted city leaders
for not following through with promises to increase drug treatment
programs, including residential detoxification. Currently, the area's only
public residential detoxification program is run by Stanley Street
Treatment and Resources in Fall River.

"It's amazing that we're so concerned about our image, yet we won't deal
with the reality that there is an enormous amount of drug addiction in New
Bedford," she said.

A spokeswoman for Mayor Frederick M. Kalisz Jr. said the administration was
looking at providing alternatives to methadone for intravenous drug users.
The mayor, who remains opposed to a needle exchange, also has asked his new
human services director to look into the issues of AIDS and drug use, said
spokeswoman Bernadette Coehlo.

A team of local outreach workers headed up by Kym Barboza-Owens,
interviewed and performed HIV tests on intravenous drug users on the
streets and in bars between November 1997 and January 1998 for the study.
The goal was to find people who were not enrolled in drug treatment programs.

Specific findings included:

29 percent of the 167 people who used needles to inject drugs tested
positive for HIV.

Thirty-one percent of those questioned thought their chances of infection
were not at all likely, while another 40 percent said their chances were "a
little" likely. Another 13 percent thought they were "likely" to be
infected, and 16 percent thought they were "very likely" to be infected.

Sixty-four percent of the respondents had shared needles in the previous
six months. However, those who shared needles were just as likely to have
the infection as those who did not.

Individuals employed full-time were less likely to be infected.

Only 13 percent used condoms always, while 54 percent indicated they never
used condoms.

Within the last six months, 86 percent of the users had used heroin, 67
percent crack, 45 percent marijuana and 75 percent had used multiple drugs.

Of the people who injected drugs in the past six months, 15 percent did so
one to six times per week; 41 percent did so 7 to 21 times per week; and 44
percent did 22 times or more per week, an average of more than three times
a day.

The infection rate was 20 percent for whites and 46 percent for non-whites.

Outreach workers with the New Bedford group Treatment on Demand distribute
packets containing bleach for disinfecting syringes and condoms, as well as
information about HIV testing and prevention.

Many heroin addicts use the bleach, Ms. Barboza-Owens said. But not
everyone is aware of the need.

The survey found those who had not been tested were more likely to be
infected (46 percent) than those who had been tested (26 percent). This
indicates that prevention education efforts may not be reaching a large
segment of the drug using population, she said.

"The reality of it is there is still a group of active IV-drug users still
not targeted or getting the help to make that leap to get treatment or just
to keep themselves safe," she said.

Ms. Barboza-Owens hopes the study will spark efforts to promote greater
awareness of HIV and the importance of being tested.

HIV/AIDS first began spreading among people who started injecting heroin in
the 1970s, she said. Many of these people were part of a small community of
friends and relatives who became infected because of the false sense of
security created by knowing their fellow users and sex partners.

"That mindset is still here in the city," she said. "People are less
inclined to worry."

The state chose New Bedford for the survey because of the high rate of AIDS
infection attributed to drug use, Dr. McGuire said.

As of Dec. 1, 1998, some 461 AIDS cases had been reported in New Bedford,
one of the highest rates of infection in the state, according to the
Department of Public Health.

Keys to addressing the HIV/AIDS and drug epidemics include strong
partnerships between local health departments, political leaders, social
service providers and health agencies, as well as consumer and church
groups, she said.

"What you need is everybody at the table," she said.

"The people of New Bedford should use this as a new opportunity to jump
start an even more aggressive approach to the epidemic. We only have 29
percent of the people who are currently using infected. Let's not let the
other 70 percent also become infected." 
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MAP posted-by: Mike Gogulski