Syringe-exchange programs in New Haven and Connecticut are facing funding problems, as well as a negative stigma that surrounds distributing needles to intravenous drug users despite almost two decades of sustained success and a great deal of local and national attention.
Syringe-exchange programs — also known as SEPs — work to prevent the transmission of HIV/AIDS and other diseases by replacing drug users’ used syringes with sterilized new ones. Established in 1990, the New Haven Needle-Exchange Program was one of the first of its kind in the nation and a 1991 study by Yale professors Edward Kaplan and Robert Heimer in 1991 showed a one-third reduction in the percentage of infected needles retrieved by needle-exchange staff. But despite their success in repeated programs across the country, Connecticut SEPs face continual problems in garnering financial, ideological and logistical support.
Matthew Lopes ’72 EPH ’77, chair of the Mayor’s Task Force on AIDS, said he thinks Connecticut’s SEPs for the most part receive adequate monies from the state, but he would prefer more funding so that the programs could operate in the evening, expanding their accessibility.
Each weekday except Wednesdays the program’s van makes five stops between 10 a.m. and 4:15 p.m. in New Haven areas known for high drug traffic. Every Wednesday, the program splits its time between making home deliveries and a regularly scheduled stop. Because of a union contract, the health department must compensate employees who work evening hours with overtime pay, which is more expensive for the organization.
“I have a staff that is amenable to working longer, but we can’t find the funding,” Lopes said. “That’s a drawback.”
American Public Health Association Student Assembly member Robert Nelb ’08 said the program’s inability to operate at night hinders its effectiveness. Nelb said the needle-exchange program should be examined more closely to ensure that it is achieving its original goals.
“It’s easy after a law or program is passed to give up the fight and move on to a new subject,” he said. “There are ways to make this service better at achieving its important goal.”
After Kaplan and Heimer’s study gained national recognition in 1991, many in the world of public health saw the study as providing a sound basis for SEPs. The research was integral in expanding SEPs, said Shawn Lang, director of public policy for the Connecticut AIDS Coalition.
“The research done by Yale made it more viable as a public health policy,” she said. “That allowed us to add more programs around the state.”
Lang said the five SEPs in Connecticut — there are others in Hartford, Bridgeport, Stamford and Danbury — take more syringes off the streets than they distribute. There was a sixth SEP in Windham until 1997, when the site was closed after a public controversy in which it was blamed for the city’s drug problem and discarded syringes.
Funding is not the only challenge facing Connecticut’s SEPs. Although the Connecticut state legislature legalized the possession of up to thirty sets of injection equipment, law enforcement officers have been known to harass SEP clients on occasion, claiming possession of syringes as evidence of injection drug use. The American Civil Liberties Union won a lawsuit against the city of Bridgeport this summer after a judge ruled that Bridgeport police had violated a 2001 ruling that blocked officers from harassing individuals possessing syringes.
Lopes said Bridgeport’s disconnect between public health policy and law enforcement does not extend to New Haven and the rest of Connecticut. New Haven’s needle-exchange program has always had a harmonious relationship with the local police, NHPD spokesperson Bonnie Winchester said, due to a long tradition of community-based policing.
“We have a ‘hands off’ attitude and we support the Needle-exchange Program,” she said.
To some active in HIV/AIDS prevention advocacy, the stigma that causes conflicts with law enforcement also appears to lead to funding problems. Lang said support for needle-exchange programs is inhibited by the perception that SEPs promote drug addiction. She said state and private support are the only reliable sources of funding for SEPs since city funding is inconsistent and federal spending on needle-exchange has been banned since 1989.
“There’s nobody fighting for syringe-exchange,” she said. “People who are injecting drug users — people don’t see them as a constituency worth fighting for. It’s a constant battle to promote this as good public health policy, which is exactly what it is.”
Connecticut State Representative William Dyson, who serves New Haven’s 94th Assembly District, agreed that stigma surrounding needle-exchange prevents more generous funding.
“It’s not something that a whole lot of people embrace,” said Dyson, who said he has been a long-time supporter of SEPs. “It becomes risky for some people in their minds to be connected with a program that [exchanges needles].”
According to the Connecticut Department of Public Health, the Elm City has the second largest number of AIDS cases in the state, with 1,150 people reporting the virus. Hartford has the largest caseload, with 1,480 patients. Bridgeport reported 786 residents living with AIDS, making it third.