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US syringe funding ban impedes HIV and hepatitis C prevention
Liz Highleyman, 2015-12-16 07:30:00

Providing sterile syringes is a proven effective way to prevent HIV and hepatitis C virus (HCV) infections among people who inject drugs, yet the US government continues to prohibit use of federal funds for this purpose, presenters said at the 2015 National HIV Prevention Conference (NHPC) last week in Atlanta. A federal budget bill now under consideration could lift the funding ban on syringe exchange programmes.

The 'high-impact prevention' initiative from the Centers for Disease Control and Prevention (CDC) aims to target the right combinations of scientifically proven, cost-effective and scalable interventions to the right people, at the right time and in the right geographic areas – and syringe exchange and distribution programmes have been shown to fill that role for people who inject drugs.

Syringe distribution is "cost-effective and cost-saving," Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, said in his plenary talk on high-impact prevention.

"We must address the needs of people who inject drugs and in particular the opioid epidemic," added Murray Penner, executive director of the National Alliance of State and Territorial AIDS Directors, during a panel discussion following Mermin's talk. "We must end the congressional ban on use of federal funds for syringe access programs."

As previously reported, in early 2015 public health officials detected an outbreak of new HIV infections associated with injection of prescription opioids, particularly oxymorphone, in rural Scott County, Indiana (May 1, 2015 Morbidity and Mortality Weekly Report). In March the state governor declared a public health emergency allowing local authorities to establish syringe exchanges.

At the International AIDS Society conference this summer John Brooks from the CDC's HIV Epidemiology Team described efforts to determine the source of the outbreak, halt further infections, and bring affected people into care. At IDWeek 2015 researchers reported that an emergency syringe program in Scott County led to a decrease in high-risk behaviours including needle sharing over its first five months.

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