By Darryl Fears
Washington Post Staff Writer
Saturday, July 25, 2009; B01
The House on Friday approved a bill that would lift the 21-year ban on using federal money for needle exchange programs, a move that could give the District and other cities more flexibility in their efforts to prevent the spread of HIV and AIDS among intravenous drug users.
"This is the first time in over 20 years that we are on the verge of recognition by the federal government of the proven cost-effectiveness and impact of syringe exchange as a very important tool for prevention of HIV infection and viral hepatitis," said Ronald Johnson, deputy executive director of AIDS Action, a Washington-based advocacy group. "Allowing the local community to use federal funds is very critical to stopping these epidemics."
But the bill, sponsored by Rep. David Obey (D-Wis.), includes a restriction against using the money to assist any program that distributes needles within 1,000 feet of day-care centers, schools, parks, playgrounds, pools and youth centers. The House approved the measure, 264 to 153.
The District's annual appropriations bill, which passed the House on July 15, also would prohibit the city from using the money provided by the federal government for needle exchange programs near such locations.
AIDS Action said no part of the city would be eligible for a needle exchange program if the restrictions are approved.
"AIDS Action will have to continue to fight to remove the restrictions so D.C. can make its own decisions" on how to spend local and federal money, said William McColl, political director for the group.
House Democrats and AIDS activists said they would work to remove the restrictions when the House and Senate hammer out their differences in a conference committee. The Senate appropriations bill for the District approved last week carried no restrictions against using the money, and the Senate has yet to vote on the use of federal dollars for needle exchange.
D.C. Council member David A. Catania (I-At Large) called the House votes "one step forward and one step back" for the city's effort to prevent the spread of HIV and AIDS.
"There's nothing new here," Catania said. "People have been playing politics with people's health . . . for years. I'm not ready to declare defeat."
Needle exchange programs typically include treatment referrals for intravenous drug users and have been used to guide them into HIV prevention programs. The federal Centers for Disease Control and Prevention has endorsed needle exchange as a method of fighting the spread of AIDS, even as some members of Congress have fought to curtail the programs.
The District spends about a half-million dollars each year on needle exchange programs and was poised to add funding before the restrictions were approved. Catania said the programs have "channeled people into treatment in higher numbers than we originally thought possible."
In 1997, the National Institutes of Health said needle exchange programs contributed to an 80 percent reduction in risky behavior and a 30 percent decline in HIV infection. A quarter of HIV and AIDS infections in the United States were the result of drug use, according to AIDS Action.
In the District, men having sex with men accounts for 37 percent of HIV and AIDS transmission, followed by men having sex with women at 28 percent and intravenous drug use at 18 percent, according to a D.C. government epidemiology report.