In the early 1990’s I was a new physician trying to treat patients dying of AIDS contracted through shared syringes. But in those days there was no effective treatment.

A shelter for those in need

One Saturday I visited a then-illegal syringe exchange program (SEP) and found that I might save more lives volunteering on street corners than in my clinic.

Trust developed between volunteers and syringe exchange participants, many of whom were homeless and felt too stigmatized to go to standard facilities alone and therefore asked for more assistance. So we offered information and referrals to agencies that might make them feel welcome, including my own clinic.

Charting progress

In 2014 New York State embarked on a campaign to end AIDS. This would be impossible if the state did not support SEPs, beginning in 1992. At that time, over 50 percent of the new cases of HIV/AIDS were among people who inject drugs. In 2010 it was 3 percent.

Syringe exchange has been shown to be one of the most cost effective means to prevent HIV. If the rest of the country is to eliminate HIV, we must take these lessons to heart. HIV can still sweep through a population many years after syringe exchanges were first supported in some states.

A real need for help

Austin, Indiana bears witness to this; in 2015 a town of 4,200 found that nearly 200 people who were injecting opioids were recently infected by HIV spread through shared syringes. This tragedy was preventable.

Access to sterile syringes is vital; they should also be easily available in pharmacies. However, SEPs provide so much more. Well-funded programs are able to provide health care and drug treatment on site to individuals who feel stigmatized in other facilities. The provision of naloxone to individuals at risk of experiencing an overdose originated at syringe exchange programs.

Access to this lifesaving medication, which prevents opioid overdoses from becoming fatal, has swept the nation. Provision of sterile syringes and other services for people who inject drugs must as well.