November 24, 2008

Tompkins County Continues to Distribute Sterile Syringes

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There were 177,262 individuals infected with HIV/AIDS in New York as of 2006, according to the most recent data made available by the Kaiser State Health Facts website. 27,645 of these individuals were living in upstate New York. In an effort to combat the transmission of HIV, along with other blood-borne diseases, the Southern Tier AIDS Program and Tompkins County Prevention Point syringe exchange program continue to stand by their harm reduction philosophy, providing sterile syringes and information to the public.
Founded in 1984, STAP provides client services, prevention outreach and HIV testing to eight counties from six locations in upstate New York. All services are free and confidential. The Ithaca Office Syringe Exchange Program, a component of STAP, provides safer injection and sex supplies, referrals, HIV/AIDS education and on site HIV testing to individuals. Last April, another syringe exchange program opened in Jackson City as well. [img_assist|nid=33849|title=AIDS in N.Y.|desc=|link=node|align=left|width=|height=0]
“[SEPs] set up a recognition of individuals who are dealing with an active problem and at least gets them connected to other services that could be of help to them. When they are ready to take a step in another direction there is an organization there to help them,” said Barbara Jastran, Gannett clinical counselor.
According to Shannon Bloise, STAP SEP coordinator, Tompkins County SEP currently has 563 participants that have registered since August 2002 and sees anywhere from 30 to 50 patients on a regular basis. The SEP practices a “one-for-one plus 20” syringe exchange policy, meaning that when an individual comes in with a dirty syringe, they receive one clean syringe to match that, plus twenty more. Since its opening, 123,214 syringes have been returned and 125,047 sterile syringes were given out, giving TCPP a return rate of 98.5 percent.
“This shows we’re not only supplying people with syringes, but we’re also getting a lot of dirty needles off the streets,” Bloise said.
Members of the Cornell community may also utilize SEPs.
“There have been stories of students using needles to shoot steroids on this campus … We want to be careful and sensitive to not separate out populations. It could very well benefit Cornell students,” said Nina Cummings of Gannett Health Promotion.
As of 2000, in N.Y., individuals 18 years and older can purchase and/or possess 10 or fewer syringes without a prescription. N.Y. is also one of a handful of states that have given their health departments the power to establish SEPs and to exempt them from drug paraphernalia laws. According to Bloise, there are 18 registered SEPs in New York State; 13 in New York City, one in Buffalo, one in Rochester, one in Mount Vernon, one in Ithaca and one in Johnson City.
However, needle exchanges continue to be controversial, with some feeling that the programs may encourage drug use. Federal funding cannot be used to fund any syringe exchange program since Congress banned such funds in 1988. In addition, several states have restricted the funding and operation of syringe exchange programs. 47 states have drug paraphernalia laws that deem distribution and possession of syringes as a criminal penalty. Eight states and one territory also have laws that prohibit dispensing or possessing syringes without a valid medical prescription.
Supporters of SEPS cite the effectiveness of these programs and their harm reduction philosophy, arguing that individuals will engage in dangerous behavior and the best course of action is to try to reduce the harm they cause to themselves and others.
“I really do think harm reduction is very important and needle exchanges have definitely been shown to be a very effective part of control among people who abuse drugs,” said Lewis Drusin, Weill-Cornell Medical Center Prevention and Health Behavior.
The National Institute of Health Consensus Panel on HIV Prevention stated that evidence shows that needle exchanges have reduced risk behavior by as high as 80 percent and reduced HIV transmission through intravenous drug users by as much as 30 percent. Moreover, six federally funded studies through the CDC, the National Commission on AIDS, the General Accounting Office, University of California, the National Academy of Sciences and the Office of Technology Assessment show that SEPs lower HIV transmission and do not increase drug use.
It is also much more cost effective to run these programs than to undertake the healthcare costs associated with HIV/AIDS.
“It costs 36 cents to buy one clean syringe, whereas lifetime health care costs for someone with HIV is about $1 million per person. Providing a couple of syringes for a few dollars can prevent that type of cost to tax payers,” Bloise said.
Bloise also stressed that although SEPs distribute sterile syringes, individuals cannot simply walk in, get a syringe and leave.
“We provide education on ways to protect yourself and inject more safely, we give referrals not only for treatment but for shelter, food, or other needs, and most importantly we offer a very disenfranchised group of people a place to feel welcome and cared for,” Bloise stated in a e-mail.