NYC’s Syringe Exchange Programs Uses former Drug Users in HIV Prevention Efforts.
Former drug users hands out syringes.
Ex-heroin addict Kathy Reul faces her former addiction almost every day.
And it’s her choice.
Reul, who has been clean for 12 years, is a part of the AIDS Center of Queens County’s syringe exchange program where she hands out clean syringes, along with things like condoms and thick plastic bags for the disposal of used needles, to injection drug users (IDUs).
“You become very passionate when you see these people who, if it weren’t for us, would be using each other’s syringes,” she said as she stood beside the ACQC’s van in Jamaica, parked outside of Joey Tai’s Auto body shop.
Reul is a part of the program’s Peer group — all former or current injection drug users who help distribute sterile syringes — and has been for a year.
“I have been exposed to AIDS because of used needles two times – that I know of,” Reul said.
ACQC’s program has five sites in Queens.
It is one of 13 programs like it in New York City where IDUs can come to receive clean syringes in exchange for used ones, along with, HIV, hepatitis, and other sexually transmitted infections testing.
“We don’t just want to hand out syringes,” said Tina Wolf, the program’s supervisor.
Not only are syringe exchange programs in place to prevent the spread of HIV, and Hepatitis C, but their intent is to provide a place where IUDs can leave used needles.
ACQC has a “return plus ten” rule, where a person can receive ten more syringes on top of the number they bring back. Syringe Exchange Programs (SEPs) were legalized in New York State in 1992, after a slew of underground operations were formed to combat the spread of HIV through needle sharing.
The federal government does not fund SEPs, so most programs in the Big Apple are funded by the state and city or supplemented by grants from private entities.
“It’s still stigmatized,” said Wolf. “We’re not really recognized by our own government.”
According to the New York State AIDS Institute, once, 52 percent of AIDS cases in the state were IDUs. In 2006, it dropped to just seven percent.
“[SEPs] are a realistic approach to the problem,” said Angela Echevarria, ACQC’s SEP case manager.
People often use the argument that SEPs enable drug use, but most who are involved in the programs say that statistics disprove it.
“The idea is that you reduce harm,” said Nadine Ranger, a director at the Brooklyn AIDS Task Force. “A lot of people are into abstinence but the reality is, people will do drugs until they decide not to.”
In 1990, 50 percent of IDUs in the state were infected with HIV and today the AIDS Institute estimates it is down to between 10 and 13 percent. They also found that SEPs did not increase drug use.
Most SEPs also offer mental health counseling and either drug rehabilitation services, or refer patients who require other medical care.
“We try to provide a one-stop shop,” Ranger said.
But it’s not easy to do when funding is low.
“It’s a political situation,” said Nelson Gonzalez of Positive Health Project, an HIV prevention organization. “But at the end of the day we want to make sure [IDUs] survive the experience.”
With more funding, Positive Health would focus on education about SEPs and how they work, Gonzalez said. But New York City is at the forefront of HIV prevention in form of SEPs, according to Mike Duncan, who works with Voices of Community Advocates and Leaders, an organization of drug users who focus on issues like HIV/AIDS.
“Especially in New York, many people are willing to deal with drug use as a health issue,” he said. “If it’s dealt with this way, instead of criminalizing drug users, it stops alienating people from the system.”
Wolf thinks New York City could look for inspiration about expanding SEPs.
She described Safe Injection Facilities — where IDUs can go to use drugs under medical supervision — as the future of syringe exchange programs.
“We can’t stop because we’re ahead,” she said.