LOUISVILLE ESTABLISHES A
SYRINGE EXCHANGE PROGRAM
Sarah Moyer, MD, MPH
I
n June the Louisville Metro Department of
Public Health and Wellness implemented
a syringe exchange program to prevent the
spread of blood-borne pathogens such as HIV
and hepatitis C.
community support as one of the best ways to prevent such an HIV
epidemic in Louisville.
In response to escalating heroin use throughout the state, the 2015 Kentucky legislature
enacted legislation allowing local health departments to operate substance abuse outreach programs which
include syringe exchange programs. On March 25, 2015, Governor
Steve Beshear signed KRS218A.500 into law. The Louisville Metro
Council passed legislation (Ordinance No. 58, Series 2015) to enable
the Louisville Metro Department of Public Health and Wellness
to set up a needle exchange program for the city and Mayor Greg
Fischer signed the bill on May 4, 2015. The Louisville Metro Board
of Health unanimously voted its support on May 6, 2015.
The science is clear about the value of clean syringe exchanges. Public health bodies ranging from the American Medical Association
to the Centers for Disease Control and Prevention, to several U.S.
Surgeon Generals, have all endorsed them. The U.S. has 194 needle
exchange programs in 33 states and the District of Columbia. A
2005 study found that HIV rates decreased by nearly six percent in
cities that had syringe exchange programs compared to a national
increase of nearly six percent per year. The number of HIV cases
linked to intravenous drug use dropped by 80 percent in Washington
D.C. from 2007 to 2011, with the number of new cases annually
decreasing from 149 to 30.
Much of the impetus for the syringe exchange came from a rapid
spike in HIV cases fueled by IV drug use in Austin, Indiana, just
35 miles from Louisville. As of June 1, Austin, with a population
of about 4,300, has seen 160 new cases of HIV. A proportionate
increase in Louisville would result in 28,000 new HIV cases in
six months. While Louisville has not yet seen such a precipitous
rise in HIV, a syringe exchange program has garnered widespread
Syringe exchanges help to prevent the spread of HIV and hepatitis
C, not just among IV drug users, but throughout much of the rest
of the population, particularly among women and newborns. Many
women who do not use drugs are at risk for HIV and hepatitis C
because they are sexual partners of injection drug users. These
women may then pass these diseases to their children in utero.
THE VALUE OF SYRINGE EXCHANGE
PROGRAMS
(continued on page 15)
JULY 2015
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