Elected officials hear some prickly criticism over syringe litter, but they are expected to stand behind San Francisco’s needle exchange program Tuesday by supporting a seven-year contract extension.

Criticism over needle litter has increased in recent years due to an increase in drug use and the distribution of more needles, Department of Public Health Officials acknowledged during a Board of Supervisors Budget and Finance Committee hearing Wednesday on the $26.6 million contract extension with the AIDS Foundation.

However efforts to collect used needles have also increased. Among them, in July, the AIDS Foundation, in contract with The City, launched a syringe pick-up team that in its first six months collected 90,879 syringes. The crew, which operates seven days a week from 7 am to 7 pm, responds to calls and texts from residents requesting needle cleanups. Their response time averages 58 minutes.

Needle exchange programs, which the department began funding in the 1990s, are credited with reducing the spread of diseases like HIV and Hepatitis C in San Francisco. For example, the number of new HIV infections among people who inject drugs has continued to decrease annually from 106 in 2010 to 38 in 2016, according to the department.

In 2017, the AIDS Foundation and its partner organizations like GLIDE, distributed 5.3 million syringes and collected 3.3 million, a 62 percent return rate, according to data provided to the San Francisco Examiner by the Department of Public Health.

Of the collected syringes, 3.1 million were returned to syringe access sites, 59,000 were dropped off at syringe disposal kiosks and 107,136 picked up through cleanup sweeps.

In 2018, the program distributed 5.8 million syringes and collected 3.8 million, an improved collection rate of about 65 percent. There was a significant uptick in dropoff of needles at kiosks which increased to 241,080 in 2018, a more than 300 percent increase from the 59,000 in 2017.

Sweeps in 2018 cleaned up 216,969 needles, about double the amount collected by this means in 2017.

The data doesn’t include the number of needles Public Works’ cleanup crews collect.

Drug users do use multiple needles daily, Tracey Packer, DPH’s director of the community health equity and promotion branch, said at the hearing. “It varies from person to person and type of drug. People may use up to 10 syringes in a couple of days,” she said.

“In 2018, it was 5.8 million syringes. That seems like a large number. When you look at the number of people who inject, times the number of syringes they need, it would probably be around 11 to 12 million that would meet the need,” Packer said. “We are somewhere in there hoping to meet their needs.”

Before voting to send the contract to the full board, committee Chair Sandra Fewer and Supervisors Rafael Mandelman and Catherine Stefani addressed some of the concerns they say they’ve heard from constituents.

Mandelman asked health officials to put a “finer point” on why The City doesn’t require a one-for-one exchange for needles. He said there is a “narrative out there” from those who see “the proliferation of used needles out on the street” that by not offering a true exchange of a dirty needle for a clean one “we’re doing something wrong.”

“Data shows that needs-based programs that allow people to get the number of syringes that they need at that moment to get them to the next time they visit a syringe site are more effective,” Packer said. “HIV prevalence remains low and stable among people who inject and we are grateful for the support of the city leadership over the course of the HIV epidemic and San Francisco has lead the nation in syringe programs.”

Stefani said she continues to her complaints about needle litter from her constituents and was critical of the collection rate.

“The 62 percent. That’s like a D right?” Stefani said.

She suggested officials amend the contract to require increased reporting to the Board of Supervisors on issues such as cleanup rates or connection of users to services, but Mandelman said additional requirements would be onerous for the programs.

“The way to get that number higher than 62 percent is to get more of these folks off the streets, into programs and into housing,” Mandelman said.

On Thursday, however, the health department sent a memo to Stefani noting they are already working with the City Controller’s Office on an audit of syringe access and disposal that would look at all city departments and nonprofits. The memo advised against any amendments to the contract.

“Improperly discarded syringes are a public health, quality of life, and public perception issue,” said a description of the planned audit. “There is a need for a coordinated approach to measure how well the City is doing in its syringe recovery efforts, and to determine how or if San Francisco residents and visitors are better off as a result of these services.”

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