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December 1, 2016– By Laura Thomas

Today, December 1, is World AIDS Day. In 1989, I was arrested in front of the White House on World AIDS Day, demanding that then-President Bush take action on HIV/AIDS.

Among the issues we were demanding action on then, so many years ago, was the availability of sterile syringes for people who inject drugs, so they could stop the transmission of HIV. In the decades since, we have celebrated amazing victories against HIV/AIDS. We now have treatments we could only dream of then. We have pills that will prevent HIV. We have a National HIV/AIDS Strategy. We even have an effective cure for hepatitis C. And we are keeping many, many more people with HIV alive now.

And yet, it is syringe access – needle exchange – that we have been the slowest to win. It is unequivocally one of the most effective and most cost effective HIV prevention interventions we know of. It was developed and promoted by people who use drugs, always on the lookout for ways to protect themselves, their family members, and communities. It has stayed too long in the shadows of the larger HIV/AIDS advocacy movement. Syringe access still happens in urban parking lots and back alleys, provided by unpaid volunteers (of which I am proud to be one), many of us current or former drug users. It was only last year that Congress grudgingly allowed federal funds to be used for syringe access programs (except for the actual purchase of the syringes).

It is not without some anger at the cost of this very slow learning curve that I note the announcement this week from the Centers for Disease Control and Prevention that:

“The science is clear: Syringe Services Programs reduce HIV risk and are not associated with an increase in injection drug use. They are a powerful tool that can help us avoid new HIV infections, reduce injection drug use in our communities, and address other health problems faced by people who inject drugs.”

I appreciate the clarity of the CDC’s statement of support for syringe access. It comes with some very nice infographics. It also highlights the concern about increasing injection drug use among whites  – but fails to mention how racially disproportionate drug arrests and incarcerations have led to racial disparities in HIV.

The CDC points out that use of syringe access programs has increased over the last decade but “most people who inject drugs still don’t always use sterile needles” – as if that were the fault of people who use drugs, rather than the fault of drug laws, stigma against drug users, and the belief among too many elected officials that this isn’t their community’s problem. The reality is that the expansion in services has happened because of the Drug Policy Alliance and Harm Reduction Coalition’s work to change laws; determined champions like Hansel Tookes in Miami, Robert Childs in North Carolina, and UC Irvine medical students in Orange County, CA; and the many harm reduction heroes across the country still running unauthorized, underfunded programs in their communities. 

We’re not going to end the HIV/AIDS epidemic until we end the war on drugs. We aren’t going to get to zero – meaning zero deaths, zero new infections, and zero stigma – until we end the war on drugs. Syringe access is essential, as is decriminalizing drug use and opening safer drug use spaces or supervised consumption facilities.

I fear the cost in lives of a Congress and presidential administration that doesn’t understand that. And I’m ready to get arrested in front of the White House again if that’s what it takes to save the lives of people who use drugs. 

Laura Thomas is the Deputy State Director, California, of the Drug Policy Alliance. 

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