A July 23 letter from the medical adviser of the Children's AIDS Fund about needle-exchange programs likely caused confusion, as some readers may have assumed that its author was affiliated with the National AIDS Fund. Not only is the National AIDS Fund not affiliated with the Children's AIDS Fund but the National AIDS Fund supports needle exchanges as a sound public health strategy for preventing HIV infection.

The author's conclusion that needle-exchange programs are ineffective is based on incorrect information. Most research provides strong evidence of the efficacy of syringe-exchange programs in preventing the transmission of HIV, sexually transmitted diseases and other blood-borne diseases among injection drug users -- without adverse impact on communities, such as increased drug use. It makes little sense to concentrate on the four studies the writer cited, because the design of these studies and the behavioral characteristics of the study populations limit generalizing these findings to U.S. populations.

In addition to their effectiveness in reducing HIV infections, needle-exchange programs create an access point into social services, drug addiction treatment and medical care for participants. In fact, needle exchange -- as one component of a broad-based HIV prevention strategy among the injected-drug population -- is supported by many medical organizations, including the American Medical Association and the American Public Health Association.

Further, because injection drug-related HIV transmission disproportionately affects women, children also are disproportionately affected. More than half of all children with AIDS contracted the disease indirectly through injection-drug use. It is troubling that the author -- a representative of a pediatric AIDS organization -- should ignore this fact.

MARY WILSON-BYROM

Interim President & CEO

National AIDS Fund

Washington