Without a vaccine or a cure, prevention is the only tool we have to control the spread of HIV. Needle-exchange programs for intravenous drug users are good public health. Scientific research demonstrates a reduction in transmission of HIV and Hepatitis B among needle-exchange participants and there is no associated increase in drug use. A New Haven, Conn., study conservatively estimated a possible 33 percent reduction in the rate of new HIV infections among needle-exchange program clients.
Needle-exchange programs also help participants enroll in drug treatment programs, immunize them against Hepatitis A and B, and promote appropriate use of other health services. The rate of acute Hepatitis B in Humboldt County has consistently fallen since needle-exchange programs were initiated in 2000.
Current law authorizes counties and cities to operate needle-exchange programs after a local state of emergency has been declared. Recent studies have shown that 70 percent of the population in North Coast and Sierra counties support the concept of needle exchange. Needle-exchange programs operate in 14 out of 58 local public health jurisdictions. AB 2871 (Berg) would eliminate the need to declare a state of emergency every two weeks to enact a needle-exchange program.
The legislation is simple and keeps decision-making local, allowing local participation in creating and conducting a program tailored to the unique concerns of the community. Such local control is consistent with the fact that public health programs in California are primarily carried out by county and city health departments. According to local health officers, up to eight counties would be able to initiate needle exchange programs if AB 2871 were passed, considerably decreasing infections spread by needle sharing in the state.
Amendments to AB 2871 have been proposed by the governor's office and by some law enforcement officials who are not supporters of needle-exchange programs. The proposed amendments would burden local governments, set restrictions on local programs that would hamper effectiveness and require extensive unfunded research and reporting to prove again that needle exchange programs are safe and effective. These requirements are particularly unrealistic since the state of California has not given any money for operation of needle-exchange programs despite their proven safety and effectiveness. Most programs struggle on scant donations and grant funding.
The governor should sign AB 2871 as proposed by Assemblymember Patty Berg and allow counties to conduct needle-exchange programs under the scientific direction of the local health officer to meet their own specification.
Dr. Ann Lindsay is Humboldt County health officer. She lives in McKinleyville.