The leading provider of clean needles to drug addicts in the District to help stem the spread of AIDS plans to shut its doors by the end of the month, officials said Wednesday, in the city that has the highest HIV/AIDS prevalence rate in the country.
Michael Rhein, president of the board of PreventionWorks, said dwindling private donations, delays in city funds and high turnover of top managers at the nonprofit agency in recent years were among the factors that led to the decision to close Feb. 25.
PreventionWorks has been distributing free needles for more than 12 years. It provides about one-third of the free needles in the city, distributing about 100,000 sterile syringes to 2,200 people last year.
At least 3 percent of D.C. residents have HIV or AIDS. The disease's primary mode of transmission is men having sex with men. Heterosexual transmission and injection drug use follow closely.
The needle exchange program in the District has long been politically controversial. Until about three years ago, PreventionWorks was the city's only provider because of a decade-long congressional prohibition against city funding for needle exchanges.
In 2007, Congress ended that ban, allowing the D.C. HIV/AIDS administration to provide about $700,000 to four nonprofits, including PreventionWorks, to distribute needles, mostly in high drug-trafficking areas. In 2009, the congressional threat reappeared but was ultimately unsuccessful.
"It's troubling, because if you played out the worst-case scenario and you think about that number of people who somehow no longer have the protection of clean needles, in the final analysis, it's the larger community that doesn't have protection," said George Jones, executive director of Bread for the City, which provides approximately 800 clean needles to about 45 clients monthly at its medical clinic.
"They're going to be leaving a big hole in the community," said Cyndee Clay, executive director of Helping Individual Prostitutes Survive (HIPS), which provides about 50,000 clean needles a year. The organization focuses mainly on outreach to sex workers.
Clay said she expected the remaining groups to fill the gap where possible, but was unsure how quickly that could happen. PreventionWorks relies on mobile outreach; Bread for the City treats people at its clinic.
PreventionWorks uses a retrofitted medical van that travels to 12 locations across the city. It also does HIV/AIDS testing and provides condoms and referrals for drug treatment.
In many ways, Rhein he said, his group is often the only access that drug users on the street have to health and medical services. "We work with our clients without judgment, even though their activities may be illegal," he said. "We meet with them where they're at, to improve their health."
Whatever sterile syringes the group has left Feb. 25 will be given to the others doing needle exchanges, including Family and Medical Counseling Services, the other main provider.
At a meeting with D.C. health department officials Wednesday, the city suggested that it might be able to redirect some of the money that had been originally intended for PreventionWorks, Rhein said. He said PreventionWorks plans to work with the other groups to figure out how the coverage gaps will be filled, including additional training. The city has asked for proposals by next week, he said.
PreventionWorks received about $300,000 a year from the District for its needle exchange program. It has also been waiting for $130,000 that was approved in October, Rhein said.
Mohammad Akhter, acting director of the HIV/AIDS administration, said the health department was working closely with the other providers "to ensure that those clients served by PreventionWorks will continue to receive vital needle exchange services."
In a statement, he praised the group for its work and said officials want to increase services for needle exchanges.