Hearings on Needle-Exchange Begin in Allegheny County, Pa.

The first in a series of hearings on a proposed needle-exchange program for intravenous drug users will be held Saturday in Allegheny County, Pa., the Pittsburgh Post-Gazette reports. To combat a rise in the number of HIV and hepatitis C infections reported among IV drug users, the county health department has proposed creating a legal needle-exchange program. In Pennsylvania, possession of a syringe without a prescription is currently a misdemeanor offense and is punishable by up to a year in prison. The declaration of a "health emergency" by the county health director is all that is needed to suspend that law, an action already taken by Philadelphia officials. Last year, HIV testing turned up 59 new cases of HIV in the county, 21 among gay males and 18 among heterosexual IV drug users. In the previous year there were 20 cases among gay males and only eight among IV drug users. There are believed to be 13,000 to 20,000 IV drug users in the county, and advocates claim a needle-exchange program would "provide better access" to that community in order to ensure that IV drug users are taking precautionary steps to protect themselves against HIV. Health Department Director Dr. Bruce Dixon said his agency plans to select a group to develop an exchange "pilot project," to be regulated but not funded by the county. Prevention Point Pittsburgh Inc. has been running an "underground" exchange program for six years, and co-founder Stuart Fisk said that the group will "demand" to be part of the county's development plan. Group volunteers annually distribute condoms and about 310,000 syringes to Pittsburgh area IV drug users. "We have the experience and the contacts," Fisk said, adding that the organization's "preference" would be to "continue to operate on our own." Prevention Point Pittsburgh is one of several groups that plan to testify at the health department hearings and submit written endorsements from clients. Next month the group will undertake a $5,000 research project, supported by the Beth Israel Institute for Chemical Dependency in New York, to study how needle-exchange services have changed behavior among IV drug users. A CDC study released last June said that the 113 exchange programs operating in more than 30 states, as well as Washington, D.C., and Puerto Rico, have reduced the spread of HIV by nearly 30% and have cut the prevalence of "risk behavior" by 80%. Dixon estimates that the nine-member county board of health will not hand down a decision on the needle-exchange program until November, after it has had time to review the hearings' findings (Weisberg, Pittsburgh Post-Gazette, 5/8).