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." - --- MAP posted-by: Mike Gogulski