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Needle Exchange
Demonstration Pilot
Begins This Summer

By Fred M. Jacobs, M.D., J. D.
Commissioner, Department of
Health and Senior Services
three syringes with needles

This summer, the Department of Health and Senior Services will authorize and closely monitor up to six needle exchange demonstration projects in eligible municipalities whose governing bodies choose to participate. The goal of this three-year demonstration project is to save as many lives as possible by helping to prevent the spread of HIV/AIDS among intravenous drug users.

Meeting a Need
The public health need for this kind of program is tremendous. New Jersey has the highest rate of HIV/AIDS cases among women, the third highest rate of pediatric cases and the fifth highest rate of adult HIV/AIDS cases. More than 68,200 HIV/AIDS cases have been identified in New Jersey since public health officials began tracking the virus. Currently, more than 33,300 people are living with HIV/AIDS in New Jersey, and 75 percent of all HIV/AIDS cases occur among adults and adolescents.

Successful Needle Exchange
While a needle exchange may be new to New Jersey, it has operated successfully around the world since the first program began in Europe more than 20 years ago. Currently, there are 185 needle exchange programs operating in 36 states as well as in Washington D.C., Puerto Rico, and Native American lands. New York City, Philadelphia, Boston, and Washington, D.C., the major metropolitan areas surrounding New Jersey have already begun to use this life-saving, harm reduction strategy. Studying the programs in each of these cities has allowed New Jersey to develop a program instituting proven best practices that have been implemented successfully.

Needle exchange will only take place in a face-to-face intervention between voluntarily participating drug users and program staff. The programs will be required to train staff, collect data on participants, record the number of syringes exchanged, set up referral relationships with other health and social service organizations and track those referrals.

Program Requirements
Municipalities interested in applying will be required to adopt an ordinance authorizing the establishment of a program; have a minimum of 350 cases of individuals living with HIV/AIDS within the municipality as of December 31, 2006; and have a prevalence rate of HIV attributable to injection drug use of at least 300 citizens per 100,000.

Currently, 12 municipalities meet this criteria: Asbury Park, Atlantic City, Camden, East Orange, Elizabeth, Irvington, Jersey City, Newark, New Brunswick, Paterson, Plainfield and Trenton. The Department of Health and Senior Services has already begun working with officials in Atlantic City and Camden, and each city has already adopted ordinances authorizing the establishment of a program.

Beyond Needles
A one-for-one exchange of clean syringes will be part of a comprehensive strategy to combat HIV/AIDS. Exchange program participants will be offered referrals to a variety of medical and social services for drug treatment, hepatitis, HIV, sexually transmitted diseases, TB, mental health problems and other medical conditions.

The strategy will also include an educational component designed to address high-risk behaviors and ways to reduce risk related to sexual activity and drugs.

And the program will be evaluated by academia to determine its effectiveness.

The legislation creating the syringe exchange demonstration project also authorized the appropriation of $10 million to the Department of Human Services to expand drug treatment.

Needle exchange programs are not a panacea, but are instead another tool in our arsenal to reduce the transmission of HIV and other blood borne diseases such as hepatitis.

This exchange program will not serve as an instant fix to the problem. Over time, the communities that choose to participate in this demonstration project will see a reduced rate of infection among intravenous drug users as well as an increased awareness of healthcare interventions such as HIV testing, sexually transmitted disease clinics, TB therapies and hepatitis testing, and that is a step in the right direction combating HIV/AIDS.




Article published in New Jersey Municipalities Magazine, May 2007


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