Posted on: Friday, February 15, 2002

Needle exchange program praised

By Curtis Lum
Advertiser Staff Writer

The state's needle exchange program handed out a record number of syringes last year, but the number of HIV cases dropped overall, an indication that the program is working, a New York consultant said yesterday.

In 2001, intravenous drug users exchanged 347,793 syringes, a 58 percent increase from the previous record of 219,218 in 2000, said Don Des Jarlais, who conducts annual evaluations of the program. Des Jarlais said last year's number was nearly double the 1999 total of 193,350 exchanges.

The high number of exchanges reflects the number of drug injections in Hawai'i, and Des Jarlais said a logical conclusion would be an increase in HIV cases. In the United States, 35 percent of all AIDS cases have been associated with injection drug use.

But in Hawai'i, Des Jarlais said, only 308, or 16.3 percent, of the 2,329 AIDS cases reported since 1988 are linked to intravenous drug use. Last year, five of the state's 57 reported AIDS cases were related to injection drug use.

Des Jarlais credited the low numbers to the state's 12-year-old needle exchange program, the first of its kind in the nation. He said Hawai'i's program should serve as a model to other states.

"Based on their drug injection frequencies, these participants would be at very high risk for HIV infection if they didn't have a legal source of sterile injection equipment and other services," Des Jarlais said. "These people are typically injecting three times a day."

The program began as a two-year pilot program in 1990 to prevent the transmission of HIV, which causes AIDS, hepatitis B and C, and other blood borne diseases. The idea was to provide drug users with clean syringes to prevent transmission of diseases through dirty needles.

Although the number of exchanges was high last year, Des Jarlais said there is no evidence that number of drug users is increasing. He said clients are exchanging a larger number of syringes per visit than in other years.

Des Jarlais said the program also saves the state thousands of dollars in medical expenses each year. He said it costs the state about $102,000 for each person infected with HIV.

"If the program prevents five HIV infections just amount drug injectors per year, it produces a cost savings to the state," he said. The state budgeted $360,000 for the program last year.

Department of Health director Bruce Anderson said he was pleased with the report. But he said the program faces "a number of challenges," including finding a permanent location in downtown Honolulu where most of intravenous drug use occurs.

The Health Department contracts the Community Health Outreach Work project to handle the needle exchange program. Syringes are handed out from six mobile vans on four islands and also at the Kalihi-Palama Clinic on O'ahu.

"It's important to find a place and establish a clinic where IV drug users are comfortable seeking services that may provide more focused services around there needs, and that would include not only providing sterile needles, but other support services," Anderson said. These services would include drug counselling and treatment, HIV counselling, hepatitis B vaccinations, and support groups.

The study also found that the average age of a person who exchanged needles last year was 41.8 years. These people reported that they had been injecting drugs an average 18.9 years.

Des Jarlais said that the drug of choice continues to be heroin, but he said amphetamine injection is increasing among users. He told health officials that new services to deal with this problem may have to be developed.