Pubdate: Tue, 23 Mar 1999
Source: Ottawa Citizen (Canada)
Copyright: 1999 The Ottawa Citizen


VANCOUVER (CP) - The controversy over whether giving injection drug users
fresh needles increases HIV transmission rates is expected to heat up again
Tuesday with publication of a study co-authored by Vancouver AIDS experts.

The study in the British-based AIDS journal attempts to contradict the views
that needle exchange programs (NEP) attract addicts who then share dirty
needles, driving up the infection rate.

"I dont know if it will add fuel to the fire in this controversy," study
co-author Dr. Martin Schechter, a University of B.C. epidemiologist, said

"Rather, it should take the wind out of the sails of people who have
misinterpreted our previously published studies.

"What weve been able to show in this study is that people who frequently
attend NEPs are higher risk," he said. "It is what youd hope for and what
youd expect and thats why they come to NEP and why they have higher HIV

A previous study found that 32 per cent of frequent needle exchange program
users are HIV positive compared with 14 per cent of infrequent users.

Schecter said the U.S. Congress has used those figures to veto funding of
needle exchanges.

Vancouvers needle exchange program, introduced 10 years ago, is one of the
busiest in North America, doling out more than two million needles a year
from fixed sites and mobile units.

In spite of the offer of clean needles, the prevalence of HIV among
Vancouvers injection drug users is estimated at 28 to 40 per cent.

Critics, including civic politicians and neighborhood advocates, have argued
that the program must be either ineffective or harmful.

In the study published Tuesday of 694 drug users, subjects were enticed with
$20 payments for each study visit, up to four in total.

In the drug users who used the program frequently relative to those who
didnt, there was a clear pattern of greater risk, including being younger,
spending more time living on the street and being more commonly involved in
the sex trade.

Another sign of their risk patterns is answers to questions where they
reported meeting their needle-sharing partners: through other users, on the
street, in jail, in shooting galleries, through methadone clinics, family
members or the needle exchange program, in that descending order.

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