Arizona Can Make One Simple Move To Slash HIV and Hepatitis Infections

A nurse fills a syringe with a vaccine before administering an injection at a kids clinic in Kiev, Ukraine August 14, 2019. Picture taken August 14, 2019. REUTERS/Valentyn Ogirenko
February 8, 2020 Topic: Politics Region: Americas Blog Brand: The Buzz Tags: Public HealthEpidemicHIVAIDSOpioid Epidemic

Arizona Can Make One Simple Move To Slash HIV and Hepatitis Infections

Why haven't they already?


Today I provided written and oral testimony before the Arizona House Health Committee regarding a bill that would allow syringe services programs (SSPs)to operate legally within the state. Arizona is one of 20 states that do not explicitly authorize syringe services programs and/​or have drug paraphernalia laws that prevent syringe services programs from operating. More commonly referred to as “needle exchange” programs, these programs have been proven unequivocally, since the 1970s, to reduce the spread of hepatitis, HIV, and other blood‐​borne infectious diseases, as well as soft tissue/​skin infections. They also provide a gateway to treatment for people who suffer from substance use disorder.

My Cato Institute policy analysis on harm reduction, published in December 2018, elaborates on the benefits of these programs. The first program to operate in the U.S. began in Tacoma, Washington in 1988.


In recent years SSPs have been distributing the opioid overdose antidote naloxone along with clean needles and syringes to people who inject drugs. Many also hand out fentanyl test strips (to test for the presence of fentanyl, an often‐​unwanted “contaminant” of opioids or stimulants obtained on the black market). So now SSPs are helping to lower the overdose rate in addition to reducing the spread of deadly infectious diseases.

Last month Jerome Adams, MD, Surgeon General of the United States, and Ricky Bluthenthal, PhD, Professor of Preventive Medicine and Associate Dean of Social Justice at the University of Southern California Keck School of Medicine, spoke at a Cato Institute policy forum on needle exchange programs and extolled their benefits. Dr. Adams shared his experience implementing syringe services programs as Indiana Health Commissioner under then‐​Governor Mike Pence in response to an outbreak of HIV in rural Scott County, Indiana. Dr. Adams told the audience that syringe services programs are “proven to decrease needles found in public areas and reduce needle sticks to first responders by 60 percent.” He also reported participants in syringe services programs are “five times more likely to enter drug treatment and 3.5 times more likely to cease injecting compared to those who don’t use syringe services programs.”

Prof. Bluthenthal, one of the nation’s leading experts on syringe services programs and other harm reduction strategies, provided evidence that SSPs reduce needle sharing (one of the principal causes of HIV transmission) while they do not contribute to unsafe syringe disposal, i.e., syringes on the streets. In fact, Dr. Bluthenthal pointed out that SSPs send out teams to collect syringes found on the street.

I shared the insights of Dr. Adams and Dr. Bluthenthal with the members of the House Committee. I also told the Committee about new evidence, reported last November, that needle exchange programs saved well over 1000 lives and hundreds of millions of taxpayer dollars in the cities of Philadelphia and Baltimore.

If the syringe services legislation passes the Arizona House of Representatives, it next must clear the Arizona Senate before reaching Governor Doug Ducey’s desk. Combining syringe services programs with making HIV pre‐ and post‐​exposure prophylaxis “over‐​the‐​counter” would create a “one‐​two punch” that can help make President Trump’s goal of eradicating new HIV transmission by 2030 a reality.

This article by Jeffrey A. Singer first appeared at CATO on February 6, 2020.

Image: Reuters.