Sticking point

On the eve of World AIDS Day 1999, a plea for the expansion of needle-exchange programs in Massachusetts

Those red ribbons aren't so voguish anymore, and the celebrity testimonials have waned, but AIDS continues to be a serious and deadly threat in this country and throughout the world. That's why the Phoenix, along with local activists and health-care professionals, urges members of the public to participate in the 12th annual World AIDS Day observances on Wednesday, December 1.

Dozens of World AIDS Day events are planned for Massachusetts, from a candlelight procession starting at the Boston Center for the Arts (539 Tremont Street) at 6:15 p.m. to an all-day auction on Phoenix-affiliated radio station WFNX 101.7, in which listeners can bid for tickets to a private concert by Tori Amos. World AIDS Day vigils and observances are planned for cities and towns including Brockton, Falmouth, Pittsfield, Lawrence, and Worcester.

The AIDS Action Committee of Massachusetts will also convene a group of doctors, nurses, and other health-care professionals on the State House steps on Tuesday, November 30, to ask Governor Paul Cellucci to expand statewide access to sterile needles and syringes. This is an urgent, sensible request. Needle-exchange programs have been shown to curb rates of HIV transmission among intravenous-drug users, but the growth of these programs in Massachusetts has often been stymied by elected officials who let political rhetoric and moral high-handedness get in the way of science and common sense.

Make no mistake: needle exchange is not flaky drug-reformist chic, nor is its efficacy as questionable as its critics might lead you to believe. There are more than 140 needle-distribution programs in 39 states nationwide, and exchange has been endorsed by institutions including the American Medical Association, the National Academy of Sciences, and the United States Department of Health and Human Services. The Centers for Disease Control and Prevention, the National Institutes of Health, and the Surgeon General, among other authorities, have all concluded that needle exchange significantly decreases the spread of HIV without increasing drug use.

Despite this, needle exchange continues to be a hot-button issue that frightens many elected officials, who fear looking "soft" on drugs or appearing to sanction illegal activity. But leaders who stand in the way of such programs do little but jeopardize public health. That certainly appears to be the case in Massachusetts, which currently allows for needle-exchange programs so long as they have the backing of city and town officials. In Boston, where local leaders have advocated needle exchange, intravenous-drug users now account for 29 percent of the HIV-infected population, according to AIDS Action Committee statistics. But in Worcester, where city officials have blocked a needle-exchange program, intravenous-drug users compose 53 percent of the infected population. The figures are even more grim in cities such as New Bedford (58 percent) and Lowell (60 percent), where officials have also stopped needle-exchange programs from operating.

"This crisis is clearly driven by the unavailability of sterile hypodermic needles and syringes," says Robert Greenwald, AIDS Action's director of public policy and legal affairs. "When you look at AIDS cases in Massachusetts localities, the [rate of drug-related HIV] is much higher in those parts of this state where needles are not available."

Governor Cellucci should do as Greenwald and other advocates are suggesting, and use World AIDS Day as a platform to declare a statewide public-health emergency concerning the drug-related spread of HIV in Massachusetts. At the same time, he should use his bully pulpit as the state's highest elected official to push for the widespread expansion of needle-exchange programs throughout Massachusetts. To do so would send an important and influential message to colleagues who have chosen to play politics with the public's health. But, more important, it would save lives.

What do you think? Send an e-mail to letters[a]phx.com.