April 26, 2010, 11:13PM
Frank Ordonez / The Post-StandardAIDS Community Resources Zanetta Greene listens to a young man while she, collegue Bob Forbes, and volunteer Edward Davis (far left) give out condums and information about HIV and Hepatitis from their mobile outreach van that was parked on the corner of East Fayette and Croly St. Friday afternoon. The agency hopes to use the van as a needle exchange program once it gets state approval.
Syracuse, NY -- Outreach workers who work Syracuse’s streets trying to stop the spread of HIV and other diseases want to add a new weapon to their arsenal: free syringes for drug addicts.
AIDS Community Resources, a nonprofit providing HIV/AIDS prevention and support services, is seeking state approval to start an exchange program that would collect dirty needles from injection-drug users and give them clean ones. Sharing needles can spread HIV (the virus that can cause AIDS) and hepatitis C.
The group tried unsuccessfully 15 years ago to start a syringe-exchange program in Syracuse. Hundreds of people attended one meeting, most in opposition to locating the program on the North Side. The proposal also encountered stiff opposition from community leaders, including Roy Bernardi, then Syracuse’s mayor.
Since then, every major city in the state has started a program. There are 18 programs in New York, including one launched in Albany this year by Catholic Charities.
“We’re really a hole in the middle of the state,” said Michael Crinnin, executive director of AIDS Community Resources. “It’s not a good thing we don’t have one here in Central New York.”
The group’s first proposal called for the creation of four permanent locations in the city where needles would be exchanged. That aspect of the proposal created fear that those locations would give “... someone who uses injection drugs a home to roost,” Crinnin said.
Under the new proposal, the syringe exchange program would be incorporated into AIDS Community Resources’ mobile street outreach van. That vehicle is equipped to provide testing for HIV and other sexually transmitted diseases. Outreach workers who take the van into different neighborhoods provide counseling, condoms, supplies that addicts can use to clean needles, and information about treatment and intervention.
“We’re into harm-reduction,” Crinnin said. “We have an obligation to help people understand how you can avoid transmission.”
Dr. Cynthia Morrow, Onondaga County’s health commissioner, said there is a lot of evidence showing these programs are effective. “As a public health director, I would absolutely support needle-exchange programs,” she said.
Onondaga County Executive Joanie Mahoney also backs the proposal. “If there’s a chance this can be one of the tools that prevents the increase in HIV cases, from a public health standpoint we are very supportive,” said Ann Rooney, deputy county executive for human resources.
Syracuse Mayor Stephanie Miner also supports it.
Most studies show the presence of syringe-exchange programs in communities does not increase drug use.
A 2000 report by then-U.S. Surgeon General David Satcher said there is conclusive scientific evidence that syringe-exchange programs, as part of a comprehensive HIV- prevention strategy, are an effective way to curb transmission of HIV.
The World Health Organization reached the same conclusion after reviewing more than 200 studies of syringe-exchange programs. One study cited by the WHO showed an 18.6 percent annual decrease in the HIV rate in 36 cities with syringe-exchange programs, compared with an 8.1 percent annual increase in 67 cities that did not have programs.
The federal Centers for Disease Control and Prevention says about 36 percent of U.S. AIDS cases are directly or indirectly associated with injection drug use. One injection-drug user shoots up about 1,000 times a year, according to the CDC. “Providing ways for injection drug users to safely dispose of used syringes is an important public health priority,” the CDC said in a report.
The local effort to start a program comes at a time when public health officials are investigating a spike in new HIV cases in Onondaga County among men 25 and younger. The county has seen 10 new cases in this group since December, about the same number it typically sees in a year.
AIDS Community Resources also is trying to halt the spread of hepatitis C, a leading cause of liver cancer and other liver diseases. The two leading causes of hepatitis C infection are injection drug use and unprotected sex — two of the same risks for HIV. AIDS Community Resources says 18 percent of clients in its nine-county service area are diagnosed with both HIV and hepatitis C. In Oneida County, the percentage of dually diagnosed clients is 27 percent.
Public health officials have been sounding the alarm about hepatitis C lately because there is a lack of awareness about the disease among the public, health care workers and policymakers. Many people with hepatitis C do not develop symptoms until many years after they are infected. A recent report by the Institute of Medicine said most of the estimated 4 million Americans with hepatitis C are unaware of their infection and are not getting the care they need.
Two years ago, outreach workers with the AIDS Community Resources van started handing out vouchers that injection-drug users can redeem at Harvey’s Pharmacy at 833 E. Genesee St., Syracuse, for free new syringes. Crinnin said the success of that program motivated him to make another attempt to start a syringe-exchange program.
Harvey’s is the only pharmacy that agreed to participate in the voucher program. Anyone who submits a voucher is given 10 syringes and a container for disposal of used needles.
Joanne Jimenez, assistant director of prevention services at AIDS Community Resources, said injection-drug users like the program because Harvey’s owner Gary Brothers treats them with respect.
“He doesn’t judge people,” she said.
Brothers said his pharmacy redeems 40 to 50 vouchers per month.
“I had my reservations at first, but the program has worked marvelously,” Brothers said.
He sees a lot of the same people returning to redeem vouchers. “The overall goal is to get them to change so they are not engaging in those practices that would require a syringe,” Brothers said.
Crinnin said he’s confident a mobile syringe-exchange program can reach even more drug users and get more dirty needles off the street. “If there is an easy, confidential way to secure clean needles, people will do that,” he said.
Contact James T. Mulder at 470-2245 or firstname.lastname@example.org