Article on NCHRC’s syringe decrim work
World Hepatitis Day
by Leilani Attilio
On July 28, 2012 NC Harm Reduction joined other hepatitis activists on the the white house lawn to commemorated World Hepatitis Day with a special focus on Hepatitis B Virus (HBV) and the Hepatitis C Virus (HCV). Hepatitis has reached epidemic proportions around the world, including the United States, but has largely flown under the radar in communities. Approximately 805,000 to 1.4 million people1 and 3.2 million people2 are infected with HBV and HCV in the United States, respectively. Unfortunately, people who are infected with HCV, which is the leading cause of liver transplants and liver cancer in the United States, may not have any signs or symptoms for decades, making the spread of the disease more pervasive. In addition, to give a sense to the seriousness of the disease (if the word “cancer” wasn’t enough), deaths due to HCV have surpassed those from HIV/AIDS3. In an effort to curtail further transmission and deaths, the White House hosted the fifth World Hepatitis Day on August 2nd to bring awareness to the threat of the disease across the country.
Featured panelists and speakers at the White House included Congressman Hank Johnson, who spoke about HCV as a person living with the disease, Dr. Howard Koh, the Assistant Secretary for Health for the U.S. Department of Health and Human Services (HHS), and Dr. John Ward, Director of the Viral Hepatitis Program at the CDC. The gathering was a platform to roll out strategy plans, recommendations, and tools for surveillance. For example, the CDC unveiled an online risk assessment tool for hepatitis. The five-minute questionnaire asks various questions such as year of birth and nativity. At the end of the questionnaire, the assessment tool generates a printable summary and recommendations to discuss with your health care provider.
The North Carolina Harm Reduction Coalition is working closely with the North Carolina legislature for the state to adopt recommendations supported by numerous professional medical organizations such as American Medical Association, American Public Health Association, and Institute of Medicine. These recommendations include syringe decriminalization, which would allow us to conduct syringe exchanges in North Carolina without criminal prosecution. Injection drug use is a risk factor for HCV due to practices such as sharing needles during injection. The coalition is looking forward to minimizing the risk of disease for all people and collaborating with other likeminded organizations. We hope you will join the fight. The first step is to raise awareness. Consider this step checked off.
1. Weinbaum CM, Williams I, Mast EE. Recommendations for identification and public health management of person with chronic hepatitis B virus infection: MMWR 57(RR-8):2;2008.
2. Armstrong GL, Wasley A, Simard EP, McQuillan GM, Kuhnert WL, Alter MJ. The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Intern Med. May 16 2006;144(10):705-714.
3. Ly KN, Xing J, Klevens RM, Jiles RB, Ward JW, Holmberg SD. The increasing burden of mortality from viral hepatitis in the United States between 1999 and 2007. Ann Intern Med. Feb 21 2012;156(4):271-278.
Distributing, Then Confiscating, Condoms
By MEGAN McLEMORE
Published: July 15, 2012
I MET her at 2 a.m. on a cold and windy morning in Washington, when she ran over to the outreach van to get a warm cup of coffee. Volunteers were offering condoms and health information to sex workers. She took only two condoms, and I urged her to take more. She told me that although she was worried about H.I.V., she was more afraid of the police. A month earlier, she had been harassed by officers for carrying several condoms. They told her to throw them out. She thought if they picked her up with more than a couple of condoms again, she might be taken to jail on prostitution charges.
Her story is not unique. Over the last eight months, Human Rights Watch has interviewed more than 200 current and former sex workers in New York, Los Angeles, Washington and San Francisco. The interviews were part of an investigation into barriers to H.I.V. prevention for sex workers, who, worldwide, are more than 10 times as likely to be infected as the general population. What we found was shocking: While public health departments spend millions of dollars promoting and distributing condoms, police departments are harassing sex workers for carrying them and using them as evidence to support arrests.
Many of the women we interviewed asked, “How many condoms is it legal to carry?” One wondered, “Why is the city giving me condoms when I can’t carry them without going to jail?” Some women said they continued to carry condoms despite the consequences. For others, fear of arrest trumped fears of sexually transmitted diseases and pregnancy. Most of those we interviewed told us they were afraid to carry the number of condoms they needed, and some — about 5 percent — told us they had unprotected sex with clients as a result.
Police officers confiscate condoms and prosecutors try to enter them as evidence not because it is official policy to do so, but simply because they have not been trained to do otherwise. An act of the legislature (like one bill pending in the New York State Assembly), or even a directive from a police chief or district attorney, could end the practice immediately. Categories of evidence — like testimony regarding the sexual history of rape victims — are excluded as a matter of public policy in many legal systems. In this case, the value of condoms for H.I.V. and disease prevention far outweighs any utility they might have in the enforcement of anti-prostitution laws. Law enforcement efforts should not interfere with the right of anyone, including sex workers, to protect his or her own health.
Later this month, the 19th International AIDS Conference will be held in Washington. The United States’ response to the epidemic will be in the spotlight; it is an opportunity for our government to announce new policies that protect those at risk of H.I.V. infection and to eliminate those that undermine prevention. Police and public health officials both seek to protect individuals and make our communities safer. They can — and should — work together to keep condoms in the hands of those who need them the most.
Interview on Syringe Exchange with Rick Basile,Retired Chief of Police, Ithaca, NY
Rick Basile served on an advisory committee for Ithaca, New York’s first syringe exchange program – while he was Chief of Police.
“I learned about harm reduction and syringe exchange programs during an interview,” explains Basile, a 30 year law enforcement veteran. “In Ithaca the interview process to become Chief of Police was unusual. Different people from the community came in and had about 45 minutes to ask me questions. One person, George Ferrari of AIDS Work, asked me how I felt about harm reduction and I didn’t know what it was. George explained to me about syringe exchange programs. Once I learned that they reduce needle-sticks to officers [by 66%], I was sold.”
Officers who receive accidental needle-sticks are at risk for transition of blood borne diseases, such as HIV and especially hepatitis C, a virus that attacks the liver and can lead to liver failure.
“I had a friend who was in the hospital for a year because of a needle-stick. He still has liver problems,” says Basile. “The other officer who was in the hospital with him with a needle-stick injury didn’t go home.”
According to Basile, the people at AIDS Work approached him to get his endorsement before starting up an exchange program. Even though syringe exchange programs are legal in New York, they wanted police to be on board.
“The people starting the exchange wanted my endorsement because they felt the program would go more smoothly with police support. I was asked to serve on the planning committee as well. We talked about sites to do the exchange, how often to provide the program, how to dispose of dirty needles, and what other services to provide in addition to syringe exchange.”
Apart from benefits such disease reduction and prevention of needle-sticks to officers, Rick Basile was impressed with the harm reduction component of syringe exchange, in which other services, such as HIV testing and treatment, referral to drug treatment programs, and social services are offered to people who participate in syringe exchange.
“As part of the exchange, people received education and started to learn about the consequences of drug use. Services were available for people who wanted to quit.”
Rick Basile supports syringe exchange programs because “they work. The programs get needles off the streets and lower the spread of disease. And of course the biggest selling point to me is the reduction in needle-sticks of officers. Hepatitis is really dangerous.”
Rick Basile currently serves as Program Chair of the Criminal Justice Program at Edgecombe County College.
WHEN: June 13th, 2012
WHAT TIME IS THE EVENT: Registration starts at 8:30am, and the event begins at 9 am and will go through 4pm.
WHERE: Durham, NC (Event site will be determined by the amount of people attending)
WHO SHOULD ATTEND: HIV/Hepatitis Prevention Service Workers, Law Enforcement, Public Health Officials, Harm Reductionists, Law Enforcement, Drug Policy Reformers, People Who Work With Drug Users and the Substance Abuse Community
Description of Event:
Syringe access is a vital intervention to prevent HIV and hep C infections among people who inject drugs. Fear of poor interactions with law enforcement is one of the most significant barriers for drug users in accessing syringe services, carrying sufficient sterile syringes to meet their injecting needs, and returning used syringes to appropriate disposal facilities. This training is for service providers that work with people who inject drugs and covers strategies and resources to improve relationships with law enforcement. This interactive workshop will explore these issues from the multiple perspectives of people who inject drugs, service providers and police. We will also discuss how to support participants in successfully advocating for themselves when approached by police officers and how we can build collaborative relationships with law enforcement officials and other community members.
WHO WILL BE PRESENTING: Robert Childs, Executive Director North Carolina Harm Reduction Coalition and Narelle Ellendon, Syringe Access Expansion Coordinator, the National Harm Reduction Coalition
EVENT CONTACT: Robert Childs, MPH (336) 543-8050,