AIDS initiative lacking; Needle exchange: Missing component will make it more difficult to reach national objectives.


AN INGREDIENT is missing in the Clinton administration's $156 million campaign to reduce AIDS cases in African-American and Hispanic communities. The plan does not fund needle exchange programs such as the one that has operated successfully in Baltimore since 1994.

That's despite the Department of Health and Human Services' acknowledging the effectiveness of such programs in slowing the spread of HIV without increasing illegal drug use.

The White House initiative directs money to HIV prevention programs, more drug treatment slots and local health departments that treat the medical needs of their AIDS populations.

The president's campaign responds to data showing that the percentage of African Americans among new AIDS cases has jumped from 25 percent to 45 percent since 1986. Among Hispanics, the percentage has increased from 14 percent to 22 percent.

AIDS is the leading killer of black men ages 25 to 44. The grim statistic is in part a result of intravenous drug use and of illicit sex in prisons, where the population is disproportionately African American.

The White House initiative could free up local funding for communities to pay for their own needle exchange programs. But local efforts aren't likely to have the same support or impact as a national program to provide clean needles to addicts.

The Baltimore program has distributed nearly 2 million syringes to more than 7,000 addicts in five years. Dr. Peter Beilenson, the city's health commissioner, says studies show the AIDS transmission rate among needle-exchange participants is 40 percent lower than among the general addict population.

Baltimore's success should not be ignored by a federal government searching for new ways to fight AIDS. Mr. Clinton deserves commendation for expanding the fight against AIDS, but for maximum impact he needs to add needle exchange to the public health arsenal.

Pub Date: 1/24/99

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