Findings

Congress finds as follows: (1)Each year, approximately 12,000 Americans contract HIV/AIDS and approximately 19,000 Americans contract the hepatitis C virus directly or indirectly from sharing contaminated syringes. (2)A 2005 comprehensive international review of the evidence of the effectiveness of syringe exchange programs in preventing HIV transmission shows that such programs reduce HIV transmission and are cost-effective. Eight additional federally funded research reports concluded that syringe exchange programs, as part of a comprehensive HIV prevention strategy, are an effective public health intervention that reduces HIV transmission without increasing the use of illicit drugs. Research has also shown that syringe exchange programs are important in preventing the transmission of hepatitis B and C. In 2004, Dr. Elias A. Zerhouni, Director of the National Institutes of Health, wrote Members of Congress stating, A number of studies conducted in the United States have shown that syringe exchange programs do not increase drug use among participants or surrounding community members and are associated with reductions in the incidence of HIV, hepatitis B, and hepatitis C in the drug-using population.. (3)As part of a comprehensive HIV and hepatitis C virus prevention effort, syringe exchange programs often provide HIV and hepatitis C counseling, testing, education, and tools to reduce sexual and drug use-related health risks; links to addiction treatment; overdose prevention; and referrals to other important medical and social services. Research has shown that injection drug users who are referred to addiction treatment from syringe exchange programs are more likely to enter and remain in treatment. (4)Research has shown that, by providing safe disposal of used injection equipment, syringe exchange programs significantly reduce the number of improperly discarded syringes in the community, thereby reducing the exposure of police, sanitation workers, children, and others to dangers of blood-borne disease from accidental syringe sticks. (5)Syringe exchange programs reduce the prevalence of HIV among injection drug users. A review of data from 81 cities across Europe, Asia, and North America found that, on average, HIV prevalence among injection drug users increased by 5.9 percent per year in the 52 cities without syringe exchange programs and decreased by 5.8 percent per year in the 29 cities with syringe exchange programs. (6)Syringe exchange programs are supported by American scientific and professional organizations, including the American Academy of Family Physicians, the American Academy of Pediatrics, the American Academy of Physicians Assistants, the American Academy of Addiction Psychiatry (formerly the American Academy of Psychiatrists in Alcoholism and Addictions), the American Bar Association, the American Medical Association, the American Nurses Association, the American Pharmacists Association, the American Psychiatric Association, the American Psychological Association, the American Public Health Association, the American Society of Addiction Medicine, the Association of Nurses in AIDS Care, the Association of State and Territorial Health Officials, the Infectious Diseases Society of America, the National Association of Boards of Pharmacy, the National Alliance of State and Territorial AIDS Directors, the United States Conference of Mayors, the World Health Organization, UNICEF, the World Bank, the International Red Cross-Red Crescent Society, UNAIDS, and the United Nations Office on Drugs and Crime; and United States government agencies, including the National Institutes of Health and the National Institute on Drug Abuse. (7)According to the most recent data from the Centers for Disease Control and Prevention, in 2005, 185 syringes exchanges were operating in 36 States, the District of Columbia, and Puerto Rico. Removing barriers to the use of Federal funding will empower localities to use their funding in the most efficient way to prevent HIV and viral hepatitis. (8)Despite the scientific and public health consensus that syringe exchange programs reduce HIV and do not increase substance abuse, a ban on funding syringe exchange has been enacted as part of each Departments of Labor, Health and Human Services, Education, and Related Agencies Appropriations Act since 1998. (9)A similar ban on the District of Columbia’s use of its own funds for needle exchange programs was lifted in fiscal year 2008. (10)Title XXVI of the Public Health Service Act, as added by the Ryan White Comprehensive AIDS Resources Emergency Act of 1990, is subject to a statutory ban on funding needle exchange programs.