CDC officials say that closing or limiting syringe exchanges in Philly could cause an HIV outbreak

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The Centers for Disease Control and Prevention said in a recent letter to a Philadelphia physician that stopping or limiting programs that provide sterile syringes to people with addiction could cause an HIV outbreak. Photo shows a man preparing a syringe to inject drugs near Kensington Ave. in Philadelphia in January 2020. Read more

The Centers for Disease Control and Prevention has shared a warning in the wake of Mayor Cherelle L. Parker’s proposal to stop paying for syringe services in Philadelphia: Ending or slowing such programs could result in new outbreaks of HIV, especially among people who use drugs.

The agency reiterated its support for syringe services in a May 1 letter to Ronald Collman, the director of the Penn Center for AIDS Research.

Collman has advocated for the city to continue funding syringe exchanges and wrote to the CDC, asking for the agency’s perspective as he prepared an opinion column on the health risks of defunding such programs.

The CDC’s letter was written by Jonathan Mermin, the director of the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, and echoes the CDC’s long-standing stance on syringe services.

“CDC sees [syringe service programs] as a vital part of basic public health infrastructure,” Mermin wrote, adding that the agency works closely with health departments and other organizations to support the distribution of sterile syringes to people who use injection drugs.

The CDC declined comment beyond the contents of the letter.

A spokesperson for the mayor’s office did not return a request for comment.

When writing to the CDC, Collman said he wanted to make sure that politicians understood the benefits of syringe exchanges as they prepared to vote on Parker’s budget.

“We need to be sure that facts and data are well known,” he said. “If policy makers make the decision that they’re going to degrade syringe services in Philadelphia, they must understand that it is going to lead to a marked increase of HIV infections. And those infections will be transmitted into the broader Philadelphia community.”

Parker has said that she believes syringe exchanges should continue to operate in Philadelphia — just not with city funding. Under her proposed budget, the syringe exchange program at the public health organization Prevention Point Philadelphia would lose $900,000 in city funding.

Parker has also declined to use funding from settlements of lawsuits against opioid drug manufacturers blamed for starting the current crisis to pay for sterile syringes.

City health officials have acknowledged that they anticipate an increase in HIV cases in the city as a result of the plan to defund Prevention Point’s syringe exchange program.

The CDC letter acknowledges that syringe service programs, or SSPs, have long been controversial and are sometimes perceived as enabling drug use. Indeed, several states, including Pennsylvania, prohibit the distribution of syringes for illicit drug use, leaving syringe exchanges such as Prevention Point to operate only with the permission of local officials. And though federal dollars can support some operations at syringe exchanges, federal agencies are prohibited by law from supplying funding for the syringes themselves.

The CDC highlights decades of research showing that these programs effectively prevent the spread of HIV and other bloodborne illnesses among people who inject drugs.

“Several studies have shown that SSPs are not associated with increased illegal drug use, crime, or environmental presence of used syringes,” the CDC’s Mermin wrote.

He noted that many organizations offering syringe services, including Prevention Point, also offer other health services, including treatment for HIV and connections to addiction treatment. Exchanging used syringes for sterile ones at health organizations can allow people in active addiction to build trust with health-care providers and gain stability that helps them consider treatment, Mermin wrote.

“People with substance use disorders often do not access health-care services at traditional venues because of mistrust and experiences of stigma,” he wrote.

Shuttering syringe exchanges can have serious health consequences. “When SSPs are closed in communities, former SSP participants describe more frequently injecting with non-sterile syringes and engaging in a range of high-risk injection practices that can lead to infections,” the CDC letter states.

“Supporting and expanding SSP infrastructure in combination with other prevention interventions would benefit HIV control efforts in Philadelphia.”…Read more by Aubrey Whelan

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