Needle Exchange

Washington DC is the only city in the country barred from using local tax money to help finance needle exchange programs. Today in the NYT, there's an article about Ron Daniels, an ex-drug user himself who works with an annual budget of $385,000 from private donations running his own needle exchange program in DC. He is also HIV positive, which 1 in 20 people in DC also are, making it the city in the United States with the highest infection rate.

Among men, using infected needles to shoot drugs is the second most common way of contracting HIV, behind sex, and for women, it's the number one method. The infection rate is going up, though, especially for hetersexual black women, who are the fastest growing segment of the population to become infected. Many people attribute this to there still being such a large stigma against homosexuality in the black community, so many black men are still very closeted and in relationships with women, while having sex with men on the side. It's called "being on the down low." There have even been movies made about it.

I don't know that I've ever really given much thought to needle exchange programs, but after working in an AIDS hospice for over a year now, they seem pretty necessary. The majority of the residents we have in there are not middle-aged or young gay men, as one might expect. They're mostly very, very poor black people, usually from the street or direct from prison, and most of them are heterosexual drug users. Some are clean when they come to us, some aren't. A lot of the women have been prostitutes, and there are more women than you'd think. And they're all black. At least ever since I've been there.


Back at the Winnebago, Yvonne Zywusko, a 39-year-old prostitute, climbed on board, shaking in withdrawal from not having used heroin in over a day.

“Look at me,” she said as she dropped two used needles in the bucket. “I wasn’t raised this way. I went to Catholic school. My family had a lot to offer me, and I missed out.”

Reaching out to prostitutes is an especially high priority of Mr. Daniels’s program, since they have great potential to spread H.I.V.

Seeming disgusted with herself, Ms. Zywusko described how she sold her body and slept in stairwells, but she began shaking her head as she added that she was still not ready or able to kick her addiction.

She added that the one line she was trying not to cross is sharing needles. “I got checked in January. It was negative,” she said about her last H.I.V. test. “I’m lucky.”

UPDATE: Texas is the only state in the whole country(!) that doesn't allow needle exhange programs of any kind, despite being the state with the 4th highest drug-related AIDS infection rate. Apparently, just this past week, a Texas House committee, led by chairwoman Dianne White Delisi (R - Temple), killed a bill that would have made it legal. The bill's author was Sen. Bob Deuell, R - Greenville.

As of 2001, there was an underground needle exchange program operating out of an unmarked van. I wonder if they're still around.