Mayor Cherelle Parker is losing progress in the fight against HIV/AIDS
If the mayor and the Kensington Caucus make it harder or impossible for people in Kensington to access clean syringes, they will have thousands of new HIV infections on their consciences.
In 1991, ACT UP Philadelphia, the AIDS Coalition to Unleash Power, started the first syringe exchange program in Philadelphia, which became Prevention Point Philadelphia. Research by George Washington University has demonstrated that Prevention Point’s syringe exchange program has prevented tens of thousands of cases of HIV over its 30-year history. Collectively, this has saved taxpayers over $182 million a year, or $1.8 billion over the lifetimes of those who avoided contracting HIV.
Syringe exchange reduces the spread of HIV by removing barriers to accessing prevention tools. Just like providing free access to condoms reduces the spread of HIV/AIDS without encouraging more sexual behavior (just safer sex), syringe exchange makes drug users less likely to contract and spread HIV without increasing drug use (and in many cases, being part of decreasing drug use).
In Philadelphia, we have started to see a slight increase in HIV rates in the last several years, especially among people who inject drugs. This can be attributed to the spread of fentanyl in the illegal drug supply, which breaks down faster in the body, requiring more injections to avoid dangerous withdrawal symptoms. With limits placed on the number of syringes Prevention Point can exchange, but demand creeping up, more Philadelphians are returning to sharing or reusing syringes, a practice that had dropped dramatically when Prevention Point opened.
Mayor Cherelle L. Parker and the Kensington Caucus’ push to move Prevention Point from Kensington and end city funding for syringe exchange will create more barriers to accessing clean syringes, but it will not create any new barriers to accessing injectable drugs in Kensington. The impact on quality of life for neighbors will be minimal. People in active addiction need opioids and want clean syringes; if the drugs stay and the clean syringes leave, they will reuse syringes.
If Mayor Parker and the Kensington Caucus make it harder or impossible for people in Kensington to access clean syringes, they will have thousands of new HIV infections on their consciences. Syringes, which cost just a few cents, are incredibly powerful at preventing HIV infections, which are complex and costly to treat over an individual’s lifetime.
Philadelphia can learn from the experiences of Zurich, where in the 1980s, thousands of people gathered in “Needle Park” using injectable drugs. Streets were littered with garbage and needles. Overdose and HIV rates were staggering. Police in riot gear pushed people out of parks and arrested people in droves. But most simply fled to other areas of the city, and nothing changed.
This shifted when Switzerland implemented an approach designed to reduce public consumption and provide access to services. Building on its universal health care and quality affordable housing, Switzerland was able to scale up a response with several key principles:
Low barriers to access. Within 20 minutes of entering a clinic, people can start medically assisted treatment, obtain prescriptions to continue treatment at home, and do not need to prove abstinence from nonprescribed substances to maintain their treatment.
Multiple treatment options.
Long-term support.
Integrated care. In addition to addressing addiction, treatment centers connect people to housing and health care, including mental health care, even while they are still actively using street drugs.
When these more “liberal” policies were implemented, both HIV infection rates and opioid use in Switzerland dropped. Theft decreased by 98%. Law enforcement has become some of the biggest supporters of Switzerland’s pragmatic approach to drug use.
In Philadelphia, to build on Switzerland’s model, we will need to leverage Medicaid to fund access to medically assisted treatment and create new affordable housing options. Additionally, we need to offer noncriminalized, accessible treatment through comprehensive drop-in centers — a much more effective use of the more than $100 million Mayor Parker has pledged to put toward triage centers and forced “treatment” using outdated, abstinence-only models.
Policy failures led to Prevention Point having to step in to save lives in the first place. Put Prevention Point out of a job by coming up with a real plan to provide comprehensive services for drug users, not by blaming it.
Jose DeMarco has been a member of ACT UP Philadelphia for longer than they would care to admit and is a cofounder of Black and Latinx Community Control of Health and the Michael Hinson Justice Institute.