BY TIM BONFIELD
The Cincinnati Enquirer
Although many medical experts agree that needle exchange programs can help slow the spread of AIDS, there are no plans to launch a needle exchange program in Cincinnati any time soon.
An on-again, off-again debate about needle exchange programs will resume Friday as part of a Cincinnati Health Department forum to discuss the connections between substance abuse and AIDS.
Earlier this week, it appeared that pressure to launch a local needle exchange program was growing.
"The Greater Cincinnati AIDS Consortium supports the availability of needle exchange programs," according to a draft statement provided to the Enquirer. That statement has been endorsed by AIDS Volunteers of Cincinnati (AVOC), the city's leading AIDS support and advocacy group.
But supporting the concept of a needle exchange program and actually calling for one to be launched in Cincinnati are two different things.
"We do not have a needle exchange program and have no plans to have one at this agency," said Kathryn Thompson, education coordinator at AVOC. "We feel that this is definitely something worth looking into, but that does not mean we are lobbying for one. Whether Cincinnati should have such a program is one of the things we'll be looking at Friday."
City Councilman Charlie Winburn introduced a motion Wednesday to ban spending any city money or any formal or tacit support for a needle exchange program. However, no vote was taken. The proposal was referred to council's health, social and children's services committee for future debate.
"I am for education and counseling for people who want to be helped," Mr. Winburn said. "But the government should not be involved in aiding and abetting a small population of people who want to continue immoral, unethical and illegal behaviors." In many cities, drug addicts sharing contaminated needles have emerged as a serious risk factor for transmitting AIDS, blamed for more than 30 percent of all adult cases nationwide.
Since 1995, the National Academy of Sciences and the federal Centers for Disease Control and Prevention (CDC) have come out in support of needle exchange programs.
There are at least 113 needle exchange programs in 80 cities in 32 states, according to a recent study by the Beth Israel Medical Center in New York. Of those programs, 52 percent were legal; 32 percent were illegal and underground and 16 percent were against state law but were sanctioned by a local government.
Despite laws against distributing drug paraphernalia, there are two needle exchange programs in Ohio, both located in Cleveland. But Greater Cincinnati's plan for fighting AIDS through 2001 cites needle exchange programs only as a mid-level priority, said city health commissioner Malcolm Adcock.
In September 1994, AVOC and the city health department issued a report concluding that Cincinnati did not need a needle exchange program because other types of substance abuse -- especially people who trade sex for crack cocaine -- were more serious AIDS risk factors.
Since then, not much has changed, according to the agency that runs Cincinnati's biggest methadone treatment center for heroin addicts.
"We're not seeing any mass increase in IV drug use," said Sandra Driggins-Smith, assistant executive director for the Central Community Health Board. "Here, I see (a needle exchange program) as a low or medium priority."
However, the AIDS risks connected with crack cocaine seem all too real.
"Many of our clients talk about trading sex for crack," Ms. Driggins-Smith said. "We have clients who say they've had five, six or seven sex acts in a day, and we know they aren't using condoms."
