Access to Clean Needles and Drug Paraphernalia Laws

• Pages: 89-91

Contenidos

• The Issue.
• Legal and Policy Considerations.
• Practice Examples.
• References.

Page 89

The Issue

Injecting drug use is a main pathway for the spread of HIV. While globally, most HIV is transmitted sexually, an estimated 10% is transmitted through injecting drug use (IDU). In some countries in Asia and Europe, the majority of HIV infections are due to IDU. Once HIV enters a population of intravenous drug users, it spreads quickly. For example, between 1993 and 1998, prevalence of HIV among injecting drug users in Manipur, India skyrocketed from 1 to 60 percent. From the IDU community, HIV then spreads more widely through sexual transmission.

Injecting drugs is an efficient way to transmit the HIV virus. A user may draw blood back into the syringe and re-inject the mixture of blood and trace amount of drugs to ensure more of the drug is injected. Even using a syringe without this practice can cause contamination, and a combination of drug-using culture and perceived necessity may lead to the reuse of needles. Scientists have detected viable HIV in syringes stored at room temperature for up to four weeks.

Legal and Policy Considerations

While reusing needles is dangerous, some countries have laws in place that hamper access to clean needles. In some countries, syringes cannot be obtained at a pharmacy without a prescription. Additionally, in many countries, drug paraphernalia laws make possessing syringes for drug use unlawful. The WHO has found that such legislation is a barrier to effective HIV prevention. In fact, there is evidence that restricting access to injecting paraphernalia inadvertently increases the incidence of HIV infection.

Access to sterile needles can be provided through deregulation of their possession, where they are regulated. Where buying needles is legal, drug paraphernalia laws that criminalize possession of needles when intended for drug use deter drug users from purchasing them. Police may arrest, detain, or extract bribes from people solely because they are carrying a syringe. Drug users have cited fear of arrest in numerous studies as the reason they do not carry clean needles. In places where harm reduction programs exist (including needle exchange, discussed in Topic 4.2), injecting drug users may shy away from the access provided fearing arrest. This is apparently the case even where government officials and police have agreed to turn a blind eye to injecting drug users entering and exiting...