PHOENIX -- Health-care advocates say Arizona's new needle exchange law could not only save millions of dollars in health care but also slow the spread of HIV and opioid overdoses.
The measure was passed by the Arizona Legislature and sent to Gov. Doug Ducey's desk this week. He is expected to sign the bill, which will for the first time in Arizona allow the exchange of used syringes for clean ones.
Haley Coles, executive director of Sonoran Prevention Works, said once you get an addict to come in for new needles, it opens the door for other ways to help them.
"That's where we can give our tools like Naloxone, the overdose-reversal medication, fentanyl test strips," Coles explained. "We can make referrals to treatment. This is a major way to intervene in the overdose crisis, the HIV crisis and the hepatitis B crisis."
Coles noted her group worked both sides of the aisle to convince opponents that previous anti-drug programs have failed to stem the rising tide of addiction among Arizonans. A companion bill allows distribution of kits to test street drugs for potentially deadly doses of fentanyl.
She pointed out the bill avoids spelling out any specific way to operate a needle exchange program.
"The genius of this bill is it recognizes that cities and counties and communities across Arizona are all very unique," Coles remarked. "It could happen at a treatment center. It could happen at a church. It allows communities to determine what works best for them."
Coles added despite evidence that needle-exchange programs have a positive impact on the lives of addicts, the main concern expressed by lawmakers was, "Won't it just encourage more drug use?"
"This is an argument that we've heard over and over, and all of the evidence, all of the research that's been done on these programs has never shown an increase in drug use," Coles reported. "In fact, it has shown decreases in drug use and decreases in injection drug use."
An Arizona Public Health Association study showed overdose deaths in Arizona have increased steadily over the past two decades across all categories of race, ethnicity and gender. It also found numerous anti-drug policies have failed to slow the rate of drug-related deaths.
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World AIDS Day is Dec. 1, dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV.
Thousands of people live with H-I-V/Aids in Arizona. More than 80% of those who were diagnosed with the virus in 2020 were linked to care, according to the Arizona Department of Health Services.
Anthony Petro, associate professor of religion and women's, gender and sexuality studies at Boston University, cited progress in how to medically treat the disease and noted how we speak about it has also changed. Petro said some diseases, such as HIV/AIDS, take on a set of political and moral meanings which can affect societal and even scientific views.
"When you think about public health itself, it is the application of medicine to a public and that depends upon us knowing who the public is that we care about," Petro explained.
Petro noted the early years of the AIDS epidemic brought questions about whether the imagined "American public" included certain groups such as queer people, sex workers and IV drug users. He recalled in the absence of "state support," local activists helped advance the movement. He contended it was only when medical researchers decided it was a virus, it gained a level of "prestige" and funding started to flow.
Petro added today, access to reproductive and transgender health care are issues currently walking that moral-political line.
President-elect Donald Trump has picked Robert F. Kennedy Jr. to lead the Department of Health and Human Services. Petro acknowledged Trump's selection has concerned public health experts as Kennedy has expressed a level of suspicion about whether HIV truly causes AIDS. He has instead suggested recreational drugs called "poppers" could be the real reason, which the medical community said is false.
Petro, like others, stressed a lot of work is still needed, related to HIV prevention and treatment.
"To hear someone today in 2024, thinking about those kinds of conspiracy theory approaches to thinking about HIV and AIDS, is certainly troubling, but it is not new," Petro outlined. "And I think we do have a very good infrastructure for HIV/AIDS care."
Petro reminded people about pre-exposure prophylaxis, or PrEP, which is the use of antiretroviral medication to prevent HIV. Most private insurance and Medicaid programs are required to cover PrEP services without co-pays or deductibles, according to the Centers for Disease Control and Prevention.
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Today is National HIV Testing Day. First observed in the U.S. in 1995, anyone who is sexually active is urged to get tested to know their HIV status.
The federal government underscores the importance of testing to show self-value, compassion and respect. According to the Centers for Disease Control and Prevention, almost 14,000 Hoosiers are living with HIV, the virus that causes AIDS.
Alan Witchey, president and CEO of the Damien Center, an HIV/AIDS resource in Indianapolis, said the blood test is free and confidential, and insurance is not required.
"Nobody has to know that you're coming, and you can either make an appointment or you can just walk in," Witchey explained. "It's just a quick finger prick; you will have your results in 20 minutes."
He added testing for other sexually transmitted diseases can be performed at the same time. A positive test result will alert the Damien Center staff to connect the person to support services and the clinic. For a negative result, medication is available for HIV prevention. The services are available at little to no cost.
The Centers for Disease Control and Prevention said 100,000 cases of AIDS, the condition which mutates from an HIV diagnosis, were reported in the U.S. between 1981 -- the first reported case -- and 1989. Since then, the invention of life-extending medications has lessened the public's urgency to get tested.
Witchey emphasized HIV is still growing and spreading, even as other epidemics have evolved.
"Even though you don't hear about HIV as much anymore, it is still here," Witchey pointed out. "And a lot of people still have this misconception that HIV is a death sentence, or they won't be able to afford the medications even if they are HIV-positive."
"Ending the HIV Epidemic in the U.S." is a federal program with the aim of lowering new HIV infections nationwide by 75% by next year and at least 90% by 2030. Funding will be used to zero in on locations with the most frequent HIV transmission.
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New Mexico activists are tapping today's World AIDS Day, Dec. 1, to announce they'll ask the State Legislature to provide more money for treatment and prevention.
Equality New Mexico Executive Director Marshall Martinez voiced concern that many primary care providers fail to prescribe treatments known as PrEP and PEP, perhaps worried that they are specialized and complex. His group will ask lawmakers to provide more funding to the Department of Health to initiate educational outreach.
Marshall said the treatments significantly reduce risk and the effects of AIDS: "Since the beginning of the epidemic in the '80s, we've never had as powerful of a preventive tool as we have in PrEP."
According to Martinez, the New Mexico Department of Health reports there are between 3,000 and 4,000 people in the state living with HIV.
Federal data show American Indians and Alaska Natives have over twice the rate of HIV infection as their white counterparts. They also are more likely to die from HIV infection.
Nonetheless, Martinez noted the majority of those taking preventive medications are cisgender, white men. He stressed this demonstrates how important it is for the state to reach Indigenous and immigrant communities, starting with funds to train medical providers.
"And then public messaging in those sort-of non-traditional communities and from non-traditional messengers to say, 'Hey, there's this drug called PrEP - it would prevent HIV - you should ask your doctor about it,'" he explained.
It is estimated that since 1981, more than 40 million people have died from AIDS; in some countries, it is still the leading cause of death. Currently, almost 30 million people are using therapies to inhibit HIV and prevent AIDS.
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