Pubdate: Tue, 30 Mar 1999

Source: Ottawa Citizen (Canada)

Copyright: 1999 The Ottawa Citizen

Contact: letters@thecitizen.southam.ca

Website: http://www.ottawacitizen.com/

Author: Ian Bailey

NEEDLE EXCHANGES DON'T SPUR HIV, STUDY SUGGESTS

VANCOUVER (CP) - The head of one of North Americas largest needle exchange programs is hailing a study that knocks down the idea that such programs spread diseases like HIV.

The study prepared by Vancouver researchers is based on interviews

with about 700 injection drug users and makes a point that might seem

like common sense. The study suggests most people who drop by to

exchange used needles for new ones are into lifestyles that make them

vulnerable to HIV.

But the man who led the study says the survey is an important tool to

fight for support for the programs.

Vancouver has one of the continents largest needle exchanges - an

operation that last year provided 2.4 million clean needles to

thousands of addicts who live in the citys poverty-stricken downtown

eastside area.

"People who go to needle exchanges are at much higher risk," says Dr.

Martin Schechter, a University of British Columbia epidemiologist, who

co-wrote the study with six other leading B.C. researchers.

"Therefore, its to be expected that their rate (of HIV) would be higher."

Schechter says the new study, published this month in the British

journal AIDS, is a kind of scientific revenge.

The veteran AIDS researcher says needle exchange opponents in the

United States - notably Republican Congressmen debating funding for

exchanges - were using a Schechter study from 1997 for their own ends.

That earlier study concluded the HIV rate was almost two times as high

among frequent users of exchanges than among infrequent users.

"People were quoting our study in Congress, using it to suggest that

the needle exchange in Vancouver made things worse," said Schechter.

"I felt that my data had been misinterpreted. I felt disappointed and

a bit outraged our data were being used for ideological reasons."

Schechter said he is hoping the critics will pay attention to the new

report. "My hope would be that people who misinterpreted the data in the past

would have an opportunity to look at the present data," he said.

The new data is reassuring to Judy McGuire, manager of the eastside

needle exchange operated by the Downtown Eastside Youth Activities

Society.

"The major myth is that needle exchanges help increase the rate of HIV

infection," says McGuire.

"Needle exchanges, by their very nature, have a tendency to raise

concerns in the community. What this (study) very effectively does is

show what we knew to be true: Were dealing with high-risk clients."

Last year, the exchange gave out enough needles to provide one to each

resident of the Vancouver region.

Its a large operation to deal with a large problem.

The downtown eastside, a sprawling decrepit district between

prosperous Chinatown and touristy Gastown has one of the worst rates

of HIV infection in the developed world linked largely to cocaine and

heroin addicts who use dirty needles.

The source of the problem is visible in alleys where addicts openly

shoot up. On the sidewalks, dealers peddle their illegal narcotics.

For 10 years, the exchange has been operating on the assumption that

one way to fight the spread of HIV and other diseases among injection

drug users is to provide them with clean needles. Clients also receive

condoms.

On average, clients trade six needles per visit.

Schechter said his latest findings may be of interest to other cities

in Canada that are debating exchanges. But Schechter, co-chair of the 11th International Conference on AIDS held in Vancouver in 1996, said needle exchanges are limited in curbing the spread of HIV among injection drug users.

"If you think a lonely needle exchange will prevent an outbreak, youre

mistaken," he said. "Vancouver is an example of that."

Needle exchanges need to be supported by properly funded housing,

detox beds and other services that are now missing in Vancouver, said

Schechter.

At best, he said the exchanges can provide some health services to

people who are otherwise hard to reach.

McGuire says Schechter has a point.

"We have been saying for years that we are not a silver bullet," she

said. But she said the exchange has done some good, noting workers last year

provided 38,000 referrals to other health service operations exchange

clients might have been wary about approaching.

"You do the best you can," said McGuire.

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