Tuesday, April 11, 2017

About half of Kentucky adults support syringe exchanges, meant to decrease the risk of outbreaks of HIV and hepatitis C

By Melissa Patrick
Kentucky Health News

More Kentucky adults favor syringe exchanges than oppose them, and the more they know about them, the more likely they are to support them, according to the latest Kentucky Health Issues Poll.

Kentucky's legislature approved syringe exchanges in 2015 to decrease the spread of HIV and hepatitis C, which are commonly spread by the sharing of needles among intravenous drug users. They require local approval and funding and are often called needle exchanges; a needle is part of the syringe.

In the Sept. 11-Oct. 19 survey, 56 percent of Kentucky adults polled said they were familiar with needle-exchange programs, while 44 percent weren't familiar with them; and 49 percent favored the programs, 43 percent opposed them and 8 percent said they weren't sure.

Those who were familiar with syringe exchanges were more likely to favor them. Of the 56 percent who said they were familiar, 59 percent said they favored the programs, while 37 percent opposed them. Among the 44 percent who were not familiar, 37 percent said they favored the programs, 50 percent opposed them and 13 percent were not sure.

Last year, the Centers for Disease Control and Prevention said 54 of Kentucky's 120 counties were  among the 220 most vulnerable in the nation to a rapid spread of HIV and hepatitis C infection among those who inject drugs. Sixteen of the state's counties ranked in the nation's top 25.

But the decision to support syringe exchanges hasn't come easy for many counties, often because of beliefs that they condone drug use, concerns about safety and concerns about the costs to taxpayers, not to mention a general lack of knowledge about what they do.

"Research tells us that needle-exchange programs can help cut down on the spread of HIV and hepatitis C," said Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsors the poll. "Research also indicates that these programs do not increase drug use."

A great example of how local news coverage can play a role in educating its readers about needle exchanges is found in Brad Bowman's in-depth article about Franklin County's exchange in The State Journal. This story not only explains why needle exchanges are important and describes how they work, but also paints a picture of who uses them: "The clients come from all walks of life, from suit-and-tie professionals to people who are unemployed," Bowman writes.

As of March 29, according to the state Cabinet for Health and Family Services, 31 counties had approved syringe-exchange programs, with 21 of them operational. Eleven are in counties the CDC has deemed most vulnerable to HIV and hepatitis C outbreaks. Click here for more information on specific locations and hours.

Income levels didn't affect opinions about needle exchanges, but age and education did: only 42 percent of adults 65 and older approved of them, while around 50 percent of those 18 to 64 did. Support also increased as education levels increased.

Randy Gooch, director of the Jessamine County Health Department, said in a foundation news release that while the ultimate goal of the program is to reduce HIV and hepatitis C infections, they also measure success in the number of clients who get counseling and treatment services because of the interactions they have with them.

"Our greatest success to date has been realized with our first participant, a 34-year-old female who came seven weeks straight to our program and returned on the eighth week to turn in her syringes and inform us she was checking into rehab. After four weeks of rehab, she was placed on medication-assisted treatment and often comes by to visit and say she is doing well," Gooch said.

Gooch said Jessamine County's exchange, which opened in April 2016, has served 114 clients in 347 encounters, has tested 20 percent of the clients and found that 30 percent of those tested are positive for hepatitis C. They have given out 11,361 syringes and have had 8,083 returned.

"The drug epidemic will only be controlled through a multi-prong approach of education, legislation, prevention, intervention, treatment, faith and other community components," Gooch said. "I'm extremely proud of our community for being proactive in these areas as a 'Safe Community'."

The poll was conducted by the Institute for Policy Research at the University of Cincinnati and was funded by the foundation and Interact for Health. It surveyed a random sample of 1,580 Kentucky adults via landlines and cell phones and has an error margin of plus or minus 2.5 percentage points.

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