New York Times magazine examines needle-exchange programs

Nov 23 2009

In a New York Times magazine article, Tina Rosenberg examines how needle sharing has contributed to the HIV/AIDS epidemic and the viability of needle exchange programs as a prevention strategy. Rosenberg notes, "Drug injectors don't pass infection only among themselves. Through their sex partners, HIV is spread into the general population. In many countries, the HIV epidemic began among drug injectors. … Though it has been scorned as special treatment for a despised population, AIDS prevention for drug users is in fact crucial to preventing a wider epidemic."

She continues, "Unlike with sexual transmission, there is a proven solution here: needle-exchange programs, which provide drug injectors with clean needles, usually in return for their used ones. Needle exchange is the cornerstone of an approach known as harm reduction: making drug use less deadly." Rosenberg notes that clean needles also provide a means to connect drug users with HIV counseling, tests and treatment as well as drug rehabilitation programs.

"Needle exchange is AIDS prevention that works," Rosenberg writes, pointing to recent studies supporting this claim. "All over the world, however, solid evidence in support of needle exchange is trumped by its risky politics. Harm reduction is thought by politicians to muddy the message that drug use is bad; to have authorities handing out needles puts an official stamp of approval on dangerous behavior." With government funding of needle exchange "politically unpopular," Rosenberg says that programs are often operated by non-governmental organizations and "efforts are small, isolated and often undermined by uncooperative police and health departments."

Rosenberg suggests that "Russia needs needle exchange more than any other country: its HIV epidemic is large, one of the fastest-growing in the world, and perhaps the most dominated by injecting drug use" (11/17).