Download Syringe Exchange Saves Lives and Money

Syringe Exchange Saves Lives and Money
Members of Congress should cosponsor HR 179, the Community AIDS and Hepatitis Prevention Act
(CAHP Act), which repeals federal laws that prohibit states from using their share of federal HIV/AIDS
prevention money for syringe exchange programs.
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Lifting the funding ban does not create new government spending. Lifting the ban will allow
states and local governments to regain discretion over their share of federal HIV prevention dollars. It
is time to let states decide whether access to sterile syringes is appropriate for local needs.
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Intravenous drug use is not just an urban problem. Emerging research has found that
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methamphetamine users in rural areas commonly inject the drug. Given that most rural areas do not
have active syringe exchange programs in place, HIV/AIDS and hepatitis C transmission in rural
districts is a ticking public health time bomb.
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Pay for HIV prevention now or HIV/AIDS later. Since the HIV/AIDS epidemic began, injection drug
use has directly and indirectly accounted for more than one-third (36%) of AIDS cases in the United
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States ; this equates to more than 354,000 people . The Journal of the American Medical
Association credits syringe exchange with helping to lower HIV incidence by 80% among people who
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inject drugs.
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Access to sterile syringe spares lives and saves taxpayer money. The Institute of Medicine has
concluded that: “the cost-effectiveness of needle exchange is estimated to range from $3,000 to
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$50,000 per HIV infection prevented.” The cost of a sterile syringe can be as little as 97 cents.
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The ban needlessly inflates health care costs. The estimated lifetime cost of treating an HIV
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positive person is between $385,200 and $618,900.
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Syringe exchange programs do more than just provide access to clean syringes. The Centers
for Disease Control and Prevention (CDC) reported that “many syringe exchange programs have
evolved into larger, community-based organizations that provide numerous social and medical
services to IDUs and their communities (e.g., testing for HIV and hepatitis A, hepatitis B, and
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hepatitis C; vaccinations for hepatitis A and hepatitis B; and general medical care).
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The CDC urges more funding for syringe exchange programs (SEPs) because of the
comprehensive services they provide: “SEPs are becoming part of a comprehensive approach to the
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prevention of bloodborne infections among IDUs and their communities.”
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Every established medical and scientific body to study the issue has concluded that syringe
exchange programs are essential to reducing the spread of HIV/AIDS, hepatitis C and other
infectious diseases: including the National Academy of Sciences, American Medical Association,
American Public Health Association, Centers for Disease Control and Prevention, and President
George H.W. Bush's and President Clinton's AIDS Advisory Commissions.
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Eight government reports concur that syringe exchange programs do not increase drug
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use. No reports contradict this finding.
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Syringe exchange programs protect children. The American Academy of Pediatrics urges that
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"pediatricians should advocate for unencumbered access to sterile syringes…” and recognizes that
syringe exchange reduces the number of contaminated needles dropped on the street and reducing
the number of children born with HIV/AIDS.
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Grant KM, Kelley SS, Agrawal S, Meza JL et al., “Methamphetamine Use in Rural Midwesterners.” The American Journal on
Addictions, 16: 79-84, 2007
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U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Drug-Associated HIV Transmission
Continues in the United States, 2002, Accessed via the Internet: http://www.cdc.gov/hiv/resources/factsheets/idu.htm
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Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, HIV/AIDS
Surveillance Report: Cases of HIV infection and AIDS in the United States and Dependent Areas, 2005, Vol. 17, Revised June
2007, p. 12, Accessed via the Internet:
http://www.cdc.gov/hiv/topics/surveillance/resources/reports/2005report/pdf/2005SurveillanceReport.pdf
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Hall HI., Song R., Rhodes P. et al., “Estimation of HIV Incidence in the United States.” Journal of the American Medical
Association, 6 August 2008; 300(5): 520-529
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Institute of Medicine, Division of Health Promotion and Disease Prevention, Committee on HIV Prevention Strategies in the United
States, No Time to Lose: Getting More from HIV Prevention, Monica S. Ruiz, Alicia R. Gable, Edward H. Kaplan, Michael A. Stoto,
Harvey V. Fineberg, and James Trussell, Editors, Accessed via the Internet (National Academy Press):
http://www.nap.edu/catalog.php?record_id=9964#toc
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Centers for Disease Control and Prevention, Syringe Exchange Programs 2005: http://www.cdc.gov/IDU/facts/AED_IDU_SYR.pdf
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Schackman BR., Gebo KA., Walensky RP et al., “The Lifetime Cost of Current Human Immunodeficiency Virus Care in the United
States.” Medical Care, November 2006, 44(11); 990-997, Accessed via the Internet: http://www.unc.edu/~pnc/pop/Schackman.pdf
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Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR), November 9, 2007 / 56(44);11641167, Accessed via the Internet: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5644a4.htm?s_cid=mm5644a4_e
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Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR), November 9, 2007 / 56(44);11641167, Accessed via the Internet: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5644a4.htm?s_cid=mm5644a4_e
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National Commission on AIDS, The Twin Epidemics of Substance Abuse and HIV (Washington DC: National Commission on
AIDS, 1991); General Accounting Office, Needle Exchange Programs: Research Suggests Promise as an AIDS Prevention Strategy
(Washington DC: US Government Printing Office, 1993); Lurie, P. & Reingold, A.L., et al., The Public Health Impact of Needle
Exchange Programs in the United States and Abroad (San Francisco, CA: University of California, 1993); National Research
Council and Institute of Medicine, Normand, J., Vlahov, D. & Moses, L. (eds.), Preventing HIV Transmission: The Role of Sterile
Needles and Bleach (Washington DC: National Academy Press, 1995); Office of Technology Assessment of the U.S. Congress, The
Effectiveness of AIDS Prevention Efforts (Springfield, VA: National Technology Information Service, 1995); National Institutes of
Health Consensus Panel, Interventions to Prevent HIV Risk Behaviors (Kensington, MD: National Institutes of Health Consensus
Program Information Center, February 1997); David Satcher, Surgeon General, Evidence-based findings on the efficacy of syringe
exchange programs: an analysis of the scientific research completed since April 1998 (Washington, DC 2000); Institute of Medicine
of the National Academy of Science. No Time to Lose: Getting More from HIV Prevention (Washington, DC 2000).
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"Policy Statement: Reducing the Risk of HIV Infection Associated With Illicit Drug Use," Committee on Pediatric AIDS, Pediatrics,
Vol. 117, No. 2, Feb. 2006 (Chicago, IL: American Academy of Pediatrics), p. 569.