針頭兌換計劃，在紐約是相當常見，根據今天一份在由疾病管制局所贊助的愛滋病預防會議上所提出的報告，這計劃在愛滋病感染率上造就了一個龐大且預料不到的降低。愛滋病研究人員Don des Jarlais, MD提到：「在一九九二年，紐約立法且資助成立針頭兌換計劃。經由如此，我們見證了一個引人注目的罹病風險降低。這也已成為愛滋病預防上一個成功的典範。自從一九八零年代開始，紐約的毒癮犯曾達到五成左右的感染率。這險惡的感染數據也讓紐約成為開發世界中愛滋病最為流行的地區。」
Clean Needles Combat HIV Infections
Exchange Programs Credited for Drop in HIV Among New York City Drug Users
By Daniel J. DeNoon
WebMD Medical News
Reviewed by Tonja Wynn Hampton, MD
Aug. 13, 2001 (Atlanta) -- Needle-exchange programs, common in New York City, are behind a huge, unexpected drop in HIV infections among the city's drug users, according to a report presented today at an HIV prevention conference sponsored by the CDC.
"This is big, good news," says AIDS researcher Don des Jarlais, MD. "In 1992, New York City legalized and funded needle-exchange programs. With that we have seen a dramatic reduction in risk behavior. This has been one of the major success stories in HIV prevention."
Since the 1980s, half of New York's injection drug users at any one time have carried the AIDS virus. The sheer number of infected people made this the largest HIV epidemic in the developed world.
Now these rates have dropped drastically. By 1997, the HIV rate among New York drug users dropped to 30% -- and recent data suggests that the rate now is 20%.
In the 1980s, one out of 20 uninfected drug users became infected every year. By 1997, that rate dropped to one out of 100 -- and it may now have dropped even more.
"There are three times as many new HIV infections among those not using syringe exchange as there are among those using these programs," des Jarlais says. "Also, people in needle-exchange programs report lower rates of HIV risk behavior and are more likely to seek HIV testing and counseling."
He says the 80%-90% of New York City's injection drug users have been tested for HIV. "And those who know they are positive are much less likely to pass on a used [needle] and much more likely to use condoms when they have sex," he says.
Why does anybody care about infected junkies? Unlike drug addiction, HIV cannot be cured. And drug users who get the AIDS virus from a needle can spread the infection to their non-drug-using sex partners.
Fears that the easy availability of clean needles will increase drug use have little scientific data to support them. Study after study shows that needle-exchange programs work -- and now the New York City study shows that they can have a huge impact. Still, the U.S. government refuses to fund needle-exchange programs.
"We are actually seeing a tremendous increase in effective needle-exchange programs in the U.S.," des Jarlais says. "It's gone from 40 programs in 1990 to 168 programs today. The biggest problem is political. We still have no federal support. All of the increase is coming from local and state money, and a tremendous amount of volunteer effort."
The image of junkies who care nothing about themselves or others is inaccurate, adds Cynthia Gomez, PhD, a researcher at the Center for AIDS Prevention Studies at the University of California, San Francisco.
"There is a consistent desire to not transmit HIV to other people," Gomez says. In fact, she says, many drug users help to get other drug users into the healthcare system.
"We often hear about the person who knows they are infected and goes about infecting others, but most people who know their HIV status will reduce their risk behavior," says Helene D. Gayle, MD, MPH, outgoing director of the CDC's AIDS office. "To have continued success, we need to intensify what we do."