News from the AIDS Conference--Needle Exchange
Needle exchange may be a controversial topic in U.S. political circles, but among organizers and delegates at the international conference this week in Mexico City, it's a no-brainer.
"When it comes to prevention in IV (intravenous) drug users, there is no complexity, said Michel Kazatchkine, executive director of the Global Fund to fight AIDS, TB and Malaria. "It's needle exchange and substitution therapy, period."
Substitution therapy involves replacing an illegal substance, such as heroin, with a legal drug such as methadone. Under a doctor's supervision, the substitute is used to curb an addict's cravings while being weaned off off the illegal drug. Needle exchange is intended to reduce the risk of contracting HIV by reusing or sharing hypodermic needles.
Although the Bush administration opposes needle exchange, "the advantage in the U.S. is that local governments do it," said UNAIDS Executive Director Peter Piot.
The one twist, of course, is the District of Columbia, where Bush has threatened to kill a $650,000 clean needle program.
Russia, on the other hand, is the reverse. It supports needle exchange but opposes methadone treatment, arguing it replaces one addiction with another. Worldwide, 55 countries support methadone treatment for addicts.
"As long as Russia doesn't change its drug policies it has no chance of controlling this epidemic," Piot told international reporters at the conference. Injection drug use accounted for 66 percent of new HIV/AIDS cases in Russia in 2006, according to UNAIDS data.
Russia's refusal to consider substitution therapy "is one of the most frustrating non-developments in the whole world," said Piot.
by Ceci Connolly
Frances Stead Sellers
August 7, 2008; 5:00 PM ET
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