November 15, 2007 - Public health officials, researchers, harm reduction advocates, and program directors gathered on November 1 to celebrate the 15th anniversary of the legalization of syringe exchange programs (SEPs) in New York State. Sponsored by the New York State Department of Health’s AIDS Institute, the meeting and awards ceremony recognized the enormous success of SEPs in reducing the incidence of HIV among injection drug users.
Although syringe exchange was not legalized in New York until 1992, today’s programs trace their roots to the early 1980s, when AIDS activists and health officials began advocating SEPs as a means of curbing the spread of HIV. The earliest syringe exchange program, started in Amsterdam in 1983 by a group of injection drug users known as the Junkiebonden (which roughly translates into “users’ union”), provided a model for American cities. The first U.S. programs appeared in Tacoma, Washington, and Portland, Oregon, the latter supported by amfAR. In New York, attempts by ACT UP and other activist groups to hand out syringes resulted in court rulings that paved the way for the first publicly funded programs in the state. Reflecting on amfAR’s long-standing involvement with SEPs, Founding Chairman Dr. Mathilde Krim praised those who have worked tirelessly to get clean syringes to injection drug users. “Keep doing what you do,” she urged the audience members, “until each life is equal to every other life. It’s that simple.” Dr. Krim attributed her own passionate support of syringe exchange to the difficulties she encountered in trying to persuade officials of its importance.
amfAR awarded its first research grants to study SEPs in 1988, obtaining a waiver from the state by presenting harm reduction as a research program, rather than one oriented toward service. This amfAR-funded research was instrumental in convincing politicians that SEPs were effective and worthy of public funding. Since 1992, amfAR has collaborated closely with the AIDS Institute, administering the distribution of supplies to the 17 authorized SEPs in the state.
In 1990, approximately 50 percent of injection drug users in New York City were HIV positive; today, that number is estimated at 10–12 percent. New York’s SEPs serve a total of 121,700 individuals through storefront locations and mobile units. In addition, injection equipment can be purchased at pharmacies and other designated locations. A new model, peer-delivered syringe exchange, has successfully involved injection drug users in distributing clean syringes to other users. These and other statistics were cited by conference panelists from the AIDS Institute, the New York City Department of Health and Mental Hygiene, and the Harm Reduction Coalition to demonstrate the effectiveness of SEPs in New York State.
"While visiting a syringe exchange program," said State Health Commissioner Richard F. Daines, M.D., "I saw the remarkable work being carried out by the staff and volunteers and how the lives of program participants were being transformed for the better."
Dr. Don Des Jarlais, an amfAR-supported researcher who has been studying SEPs since they began, asserted that if current efforts continue, “we might stop needle transmission.” However, he also cautioned that harm reduction programs must address the rise of sexual transmission of HIV among injection drug users, as well as the increased prevalence of herpes among this population.
Allan Clear, executive director of the Harm Reduction Coalition, proposed a vision of the future in which SEPs will gain national legitimacy. Calling for an end to the 1988 ban on federal funding, he proclaimed, “Now is a moment of hope at the federal level.”
