Scott Burris, J.D., Temple University Beasley School of Law
T. Stephen Jones, M.D., M.P.H., Centers for Disease Control and Prevention (Retired), Zita Lazzarini, J.D., M.P.H., Division of Medical Humanities, Health Law and Ethics, University of Connecticut Health Center, Susan G. Sherman, Ph.D., M.P.H., Johns Hopkins Bloomberg School of Public Health
Injection of illegal drugs using unsterile needles and syringes has been a significant source of HIV infection in the United States, contributing to nearly one-third of US AIDS cases (CDC, 2008). The US Public Health Service deems one-time-only use of sterile syringes to be essential to reducing rates of transmission among injection drug users (IDUs) (USPHS, 1997).
A comprehensive approach to limiting HIV spread via unsterile needles includes syringe exchange programs (SEPs), sale of syringes in pharmacies and other retail outlets without prescription or other limitation, and elimination of laws and law enforcement practices that deter IDUs from possessing syringes. SEPs have the added benefit of facilitating entry into drug treatment, which is independently protective against HIV (Metzger et al., 1998).
Despite substantial evidence that expanded syringe access benefits public health without causing other harms, state laws on syringe distribution and possession, law enforcement practices, and actions by the US Congress that limit federal funding for SEPs may be inhibiting the potential of syringe access programs to prevent HIV.