Better Access To Clean Needles May Reduce Spread Of HIV Infection

June 25, 1998

PROVIDENCE, R.I. - One needle goes a long way in Rhode Island, where intravenous drug users share and reuse needles an average of 24 times, according to a study of 417 people in a pilot needle exchange program published in the July issue of the Journal of Acquired Immunodeficiency Syndromes and Human Retrovirology.

Clean new needles may be hard to find because of Rhode Island's syringe possession laws, which are among the strictest in the country. Intended to curb illegal drug use, the laws are inadvertently boosting HIV infection rates, says study author Josiah Rich, M.D., an assistant professor of medicine at Brown University based at the Miriam Hospital. More than half of the state's AIDS cases are linked to the use of injection drugs; the state is fourth in the nation in injection drug use as a cause of AIDS.

"The single most effective way to prevent the spread of HIV in Rhode Island is to provide legal access to sterile syringes," says Rich, who serves on the advisory board of the state health department's needle exchange program. Rich has been advocating new laws to reduce the penalties for syringe possession as part of a comprehensive strategy that includes drug treatment and programs discouraging drug use.

When it became legal to purchase and to possess syringes without a prescription in 1992 in Connecticut, he says, syringe sharing among HIV-infected drug users decreased from 71 percent to 29 percent without evidence of increased drug use or publicly discarded syringes. Seven major federal and independent medical science groups also support legal access to sterile syringes.

Josiah Rich M.D., (401) 793-4770,

Brown University

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