New Jersey is Failing to Save Lives

Screaming might help, if it were a cry of pain heard all over New Jersey.

But AIDS prevention doesn’t excite the voters. Needle exchange programs and the over-the-counter sale of sterile needles have no vocal public behind it. New Jersey has no ACT UP and, without the complainers and shouters, lives will be lost.

The experts are united. Over the past decade, the public health community has concluded that improved access to sterile injecting equipment is sound public policy. It is a rare public health official that opposes needle exchanges or over-the-counter needle sales.

In New Jersey, the State Health Commissioner, Dr. Clifford Lacey, laid out the arguments. New Jersey has the ninth largest population in the United States, but it ranks fifth in the number of persons sick with AIDS.

Or to put the problem in starker terms. Illinois’ 12.7 million population is 46 percent greater than New Jersey, but New Jersey has more HIV-positive people.

This epidemic in New Jersey is not driven by unsafe gay sex, the major cause is needle sharing. Lacey testified to the State Senate that infection by the human immunodeficiency virus has resulted in 64,219 cumulative cases of HIV/AIDS in the state as of June 30, 2004.

“Approximately 51 percent of those cases—more than double the national average—can be attributed to injecting drug users, their partners or their children,” Lacey said.

Only two states—New Jersey and Delaware—have neither syringe exchange programs nor deregulation of syringe purchases.

New Jersey also has one of the most dubious reputations in public health—it has the highest rate of HIV/AIDS infection among women of any of the 50 states.

And of course there are the children. New Jersey has the third highest rate of pediatric AIDS cases in the United States. Of those children, 86 percent are from minority communities.

And more children will get sick. Preventing AIDS and reducing the number of individuals who get sick is possible, but not in New Jersey.

Harm reduction is a proven policy for preventing AIDS. In 1994, Baltimore was one of the first cities to permit drug users to legally obtain sterile injecting equipment. The incidence of HIV infection among needle users in the city fell by 12 percent a year, every year for the next four years. New Jersey has the opposite experience. Individuals sick with this disease will increase from 1,500 new cases to 1,800 a year.

Lacey said that “access to sterile syringes has been conclusively demonstrated to reduce transmission of HIV and other blood-borne diseases”

With needle exchange, the number of persons contracting AIDS would decline.

It would seem that the time for action is at hand. California just authorized over-the-counter sales of needles. Philadelphia and New York have adopted harm reduction programs.

The state’s top health official told the state Senate that eight major government-funded studies found that needle access produces no new increase in drug use. Eight United States governmental agencies and policy organizations like the U.S. Conference of Mayors support the life-saving policies that allow injecting drug users to have clean needles.

Surely, the time for action is at hand.

The Assembly Health Committee has recommended viable legislation. Governor James McGreevey backed it, but the state Senate Health Committee could only find four members to support it when it needed five to release the legislation. One Democrat is adamantly against the bills. A Republican who had supported it suddenly changed positions and the legislation never left the committee.

The HIV virus, of course, will not stop and wait for these officials to make up their minds.

For the time being, the bill is dead, but the doctors and citizens who support sound public policy will not go away. They knew that they would have a more difficult time persuading the state Senate than the Assembly, so they are prepared to keep trying.

The director of the New Jersey Drug Policy Alliance, Roseanne Scotti, said, “I am neither angry nor discouraged.”

Lacey remains “optimistic that our legislators will recognize the importance of syringe exchange and the deregulation of syringe purchase at pharmacies” for fighting AIDS and coping with the health consequences of drug use.

But for now New Jersey will do nothing significant to stop the spread of the HIV virus. Nor will the citizens of Atlantic City, where one in every 48 residents is infected, be able to start their needle exchange program. Given a choice between taking action or letting the disease fester, some state senators have chosen festering.

I would be happier if New Jersey had a vital ACT UP chapter to tell the public that AIDS is a growth industry and some politicians will not let the life guards save lives, but I can settle for the confidence that the quiet voice of reason will be heard. I still believe that New Jersey will leave the “flat earth society” and accept the scientific conclusions reached over the past ten years.

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