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New law aimed at reducing spread of HIV, hepatitis

RICK CALLAHAN | 1/18/2016, 4:31 p.m.
Advocates are praising Congress’ recent softening of a longtime ban on federal dollars going to needle exchanges amid growing intravenous ...
Used syringes and needles are piled on the ground under an underpass on the west side of San Antonio where drug addicts shoot up. Bill Day of San Antonio has been the addict's source for clean needles through a needle-exchange program with the goal of keeping them from spreading disease. Eric Gay

INDIANAPOLIS (AP) – Advocates are praising Congress’ recent softening of a longtime ban on federal dollars going to needle exchanges amid growing intravenous drug abuse that’s spreading hepatitis and HIV in many states.

The new rules, which were in the spending bill signed last month by President Barack Obama, say that federal money still can’t go to buying clean needles but can be used for other program costs in communities deemed “at risk” for significant increases in hepatitis C or an HIV outbreak.

Advocates say exchanges, which provide IV drug users with clean needles and collect used ones to reduce needle-sharing that spreads diseases among users, also help get some users into drug-treatment programs.

The change is significant, because it was backed by several Republicans who previously opposed federal funding. U.S. Rep. Hal Rogers, a Kentucky Republican who heads the House Appropriations Committee, spearheaded the change because he and others realized something needed to be done to address the growing outbreaks and mounting medical costs, Rogers’ spokeswoman Danielle Smoot said.

“We can’t ignore the growing crisis. It’s happening and we’ve got to make changes, and hopefully this will help save lives,” she said.

Rogers’ state is experiencing hepatitis C outbreaks and has the nation’s highest rate of acute hepatitis C. To the north of Kentucky’s biggest city, Louisville, southeast Indiana saw a record HIV outbreak fueled largely by people abusing a prescription painkiller.

There were about 200 needle-exchange programs in place in 33 U.S. states in 2014, according to The Foundation for AIDS Research.

The softened federal ban should help many of those exchanges pay employees’ salaries, purchase vans to deliver clean needles to users and rent office space, said Daniel Raymond, policy director for the New York-based Harm Reduction Coalition, which provides training and technical assistance for needle exchanges across the nation.

“It’s definitely a victory and I think it’s a workable compromise,” he said.

While the change will eventually bring millions of federal dollars into the needle exchanges, the exact amount and the number of programs won’t be known for a year or more, said William McColl, director of health policy with the Washington-based advocacy group AIDS United.

The move is especially important for cash-strapped rural areas of states like Kentucky, Indiana, West Virginia and Ohio – all of which are dealing with outbreaks tied to heroin addiction and abuse of other opioids.

“They’re the ones who have been struggling and the federal ban has been a huge barrier,” Raymond said.

Four Appalachian states – Kentucky, Tennessee, West Virginia and Virginia – saw the rate of hepatitis C more than tripled between 2006 and 2012, the Centers for Disease Control said in a report released last year, and researchers have warned an HIV epidemic would likely follow if nothing is done.

That type of epidemic came to rural southeastern Indiana, where more than 180 people have tested positive for HIV. Nearly all of those cases have been in Scott County about 30 miles north of Louisville, Kentucky, in an outbreak driven largely by needle-sharing among people injecting a liquefied form of the prescription painkiller Opana.