The main purpose of HIV prevention among injecting drug users is to prevent suffering and save lives.  But it turns out that effective HIV prevention can also save several billion health care dollars.   

Health care researchers have explored what it would cost society if sterile injection equipment were made available across the United States through needle exchange programs and pharmacy sales of syringes.  Their conclusions are:

• It is three times more expensive to provide medical treatment for one person sick with HIV/AIDS than to prevent one new HIV infection using needle exchange programs and pharmacy sale of syringes.⁽¹⁾ 
  

• Each year, without increased access to sterile syringes by injecting drug users, as many as 12,350 persons in the United States will become infected with HIV, leading to an estimated $1.3 billion in future medical costs for them.  

Tragically - and irresponsibly - no federal HIV prevention funds are being used for needle exchange programs.⁽²⁾  The failure to permit federal funding of needle exchange programs has brought angry criticism from, among others, Dr. R. Scott Hitt, head of the President's Advisory Council on HIV and AIDS: "At best [the prohibition on federal funding of needle exchange] is hypocrisy.  At worst, it's a lie.  And no matter what, it's immoral."⁽³⁾ 

Representative Maxine Waters of the Congressional Black Caucus, a strong supporter of federal funding, put it this way:  "This is a life-and-death issue.  We can save lives with needle exchange as we try to work at getting rid of drugs in our society."⁽⁴⁾  Representative Xavier Becerra of the Congressional Hispanic Caucus has championed federal funding for needle exchange.⁽⁵⁾  The NAACP has taken a stand in favor of needle exchange.⁽⁶⁾  

So, here is the situation.  Our best science shows that a combination of needle exchange programs and pharmacy sales of syringes could save thousands of lives and several billion health care dollars.  Yet, the federal government is not funding needle exchange programs.  The result is that the federal government is spending billions⁽⁷⁾ to provide medical treatment as people suffer with HIV/AIDS, a debilitating and often deadly illness, while refusing to spend any money for a key prevention technique - needle exchange programs.

Footnotes

(1) David R. Holtgrave, Steven D. Pinkerton, T. Stephen Jones, Peter Lurie, and David Vlahov, "Cost and Cost-Effectiveness of Increasing Access to Sterile Syringes and Needles as an HIV Prevention Intervention in the United States," Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 18 (supplement), 1998, pages S133-S138. Abstract.

(2) In 1989, Congress declared that no federal money could be spent to support clean-needle programs until the federal government could provide scientific evidence that such programs both reduced the spread of HIV and did not encourage drug use. In April 1998, after a meticulous review of the scientific evidence, Health and Human Services Secretary Donna Shalala certified that the congressional mandate had been met. While Secretary Shalala did certify that needle exchange programs are effective, she did not release federal HIV prevention funds for this purpose. As of this writing, she has still not done so. 

(3) Sheryl Gay Stolberg, "Clinton Decides Not to Finance Needle Program," New York Times, April 21, 1998, page A1.

(4) Paul Bedard, "Black Caucus Targets Drug Czar," Washington Times, April 25, 1998, page 1.  

(5) Letter from Representative Xavier Becerra and Representative Maxine Waters to Secretary of Health and Human Services Donna Shalala, February 9, 1998.

(6) Kweisi Mfume, chief executive of the NAACP, "Letter to the Editor," New York Times, July 11, 1998,  page A10.

(7) In fiscal year 1999, the federal government spent $6.8 billion on care and assistance to people with HIV/AIDS. Since the number of people infected through injecting drug use were over a third of all persons living with AIDS in the United States in 1998, a substantial portion of these funds being spent for AIDS treatment is being spent for treatment for them. Richard Sorian and Jennifer Kates, "The State of the HIV/AIDS Epidemic in America," Kaiser Family Foundation Capitol Hill Briefing Series on HIV/AIDS, April 2000,  Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Cases Reported Through December 1999, vol. 11, no. 2, table 28.

For a list of other materials used on this website, see References.