New Haven’s needle-exchange program turns 25, need still widespread Needle-exchange program turns 25

Members of the New Haven Health Department’s original needle-exchange program team pose with the program van during a recent reunion. Members of the New Haven Health Department’s original needle-exchange program team pose with the program van during a recent reunion. Photo: CONTRIBUTED PHOTO — Harold Shapiro Photo: CONTRIBUTED PHOTO — Harold Shapiro Image 1 of / 1 Caption Close New Haven’s needle-exchange program turns 25, need still widespread 1 / 1 Back to Gallery

NEW HAVEN >> In its 25th year, New Haven’s syringe-exchange program has fewer clients but its success has been counted in hundreds of lives saved in the city and surrounding towns.

It started in controversy, with the AIDS crisis “fast becoming a disease that disproportionately affected people of color, (intravenous) drug users, the urban poor, women and children,” according to a 1991 report issued during the administration of then-Mayor John C. Daniels.

In 2013, the New Haven Health Department handed out 98,000 clean needles through its four outreach workers, its four-day-a-week neighborhood van, Wednesday home deliveries and even a client who delivers to others “at all hours of the day,” according to Brooke Logan, health programs director for the city. She said 339 clients are served by the city Health Department, some who take needles to give to others the department doesn’t reach directly. A small percentage of the clients are HIV positive, Logan said.

In 1990, New Haven bore “the tragic distinction of having the highest incidence of AIDS cases in Connecticut,” according to the report, co-written by Elaine O’Keefe, the city AIDS director when the needle-exchange program was launched and now executive director at the Center for Interdisciplinary Research on AIDS.

“I always credit the HIV crisis with the transformation in public health … changing that culture,” said O’Keefe. “We started those programs because of HIV. Those programs should have started before HIV.

“Now, we still have drug-addiction issues. We still have inequities that continue to full drug addiction,” O’Keefe said.

According to the state Department of Public Health, there were 295 diagnosed cases of HIV in Connecticut in 2012, but the number who were infected by IV drug use dropped from 46 percent in 2002 to 14 percent in 2012.

The needle-exchange program “was a conduit to treatment,” said Robert Heimer, professor of epidemiology at the Yale School of Public Health, who has researched the program since its inception.

“I was originally invited to participate in the evaluation,” he said. “I did the testing of syringes.” In that way, the progress of the epidemic could be tracked.

“It took about three years of negotiations to change the state laws” after New Haven started its own outreach program in 1987, Heimer said. People thought giving addicts clean needles would increase their numbers. But, he said, “there’s no evidence to suggest that a clean syringe would encourage more people to use drugs.”

At the time, AIDS was like the recent Ebola panic, except that no one knew the source and it lasted for years.

“I remember people getting jumped because you were presumed to be gay,” said George Bichele, an outreach worker for the city Health Department who is part of the exchange program.

Bichele, a former male prostitute living with HIV, said distributing clean syringes “was our way to cope and we were all terrified and some of us were still getting high.”

He and his partner “were both terrified and we wanted to have some kind of control. We were hysterical,” Bichele said. “So we started caring for our own.”

They joined Act UP, an activist organization, which disrupted a meeting of the Mayor’s Task Force on AIDS because it was perceived as not acting quickly enough.

“We needed people to know that we were worth protecting,” Bichele said. “I didn’t think I was worthy.” Now he knows “I have the right to protect myself; I have the right to protect others.”

The program was never just about exchanging used syringes for clean ones. “A lot of people come for more than just needles” said Ambritt Myers, also a city outreach worker.

There is clothing, food, rapid testing for HIV and hepatitis C and domestic violence services.

“When people do come for needles, we don’t just hand them a bag of needles and say, ‘Have a good day,’” Myers said.

“Some of us are addicts in recovery,” she said. “It helps with the addict. We can relate better. We know that you’re homeless, we know that you’re hungry. We’ve been there so we try to help them.”

While other factors have increased AIDS among the gay population since 2002, “Fortunately, now the treatment programs (for IV drug users) in most of the state don’t have waiting lists anymore.”

And while the van visits four city neighborhoods, its clients are not all from New Haven. “Even though these programs have been set up and are focused in the cities, we are seeing more opiate abuse in our suburbs,” said Heimer.

The history of the needle-exchange program is “a unique combination of advocacy and science,” Heimer said.

Money continues to be an issue. “This year, there’s going to be another 5 percent reduction that the governor recently announced,” said Logan. However, the needle-exchange program, overall, has been successful.

HIV/AIDS is “an epidemic that we have controlled, and we’ve controlled it by the application of a number of things that include fairly controversial policies … but they work,” she said.

Correction: An earlier version of this story incorrectly reported that 339 HIV-positive clients are served by the city Health Department. Only a small percentage of the clients are HIV-positive.

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