SAN FRANCISCO (AP) — Public policies on distributing clean needles to prevent the spread of HIV are inconsistent across California, with the same local governments that fund needle exchange programs charging addicts with possession of drug paraphernalia, according to a report.

The situation, which results from political concerns taking precedence over health needs, has undermined a method proven to reduce HIV transmission and “amounts to a death sentence” for injection drug users, the New York-based Human Rights Watch said in its report.

The organization’s position is that the possession and distribution of needles for HIV-prevention purposes should be decriminalized in California and across the country.

Since 1999, California has allowed local elected officials to authorize needle exchange efforts through emergency orders that must be renewed every two weeks. At least eight counties, including Los Angeles and San Francisco, and the city of San Diego have done so.

But the state, home to nearly one-eighth of the reported AIDS cases in the United States, is also one of only five in the nation where syringes can’t be bought legally without a prescription.

“The hypocrisy in California law, the discrepancy between the need for needle exchange and the restrictions on their use, is striking,” said Jonathan Cohen, the report’s author.

More than two decades into the epidemic, injection drug use accounts for at least 36 percent of all reported AIDS cases in the U.S. and more than half of the cases among women, according to the Centers for Disease Control and Prevention. Included in those figures are patients who shared needles or had sex with an infected drug user.

The report was issued as a bill that would allow residents to buy up to 30 syringes at a pharmacy without a prescription awaits Gov. Gray Davis’ signature. The governor vetoed a similar measure last year, but has not taken a position on the current legislation, according to Davis’ office.

In its report, Human Rights Watch focused exclusively on California, but said it chose the state as a case study of what is happening nationally in the United States, where “the ideology of the ‘war on drugs’ has trumped both reason and reality,” according to the group.

Although the CDC recommends sterile equipment as the best way to keep HIV from reaching drug users and their sex partners, the U.S. government since 1988 has banned federal dollars from being used to promote needle exchange programs. Opponents of the programs, including President George Bush, argue that using public dollars to provide addicts with needles amounts to government-sanctioned drug use.

Human Rights Watch gathered testimonials from 67 intravenous drug users. Some of them alleged that they had been repeatedly harassed by police after picking up their supplies from authorized exchange programs, while others said they avoided needle exchange sites because they were afraid of being arrested.

A police official in Oakland, Calif. who was interviewed for the report, however, said that while officers did not target clients of exchange programs, many such programs are located in drug-affected communities they patrol.

According to Glenn Backes of the Drug Policy Alliance Network in Sacramento, many large California counties, including Riverside and Sacramento, have not authorized needle exchange programs despite support for them from local public health officials.

John Lovell, a lobbyist for the 7,500-member California Narcotic Officers’ Association, strongly disputed the Human Rights Watch contention that needle exchange participants are targeted for arrest.

“The debate at the Capitol on needle programs is pretty intense and there are pretty articulate advocates for needle programs,” Lovell said. “I have never heard anyone on the advocacy side make that allegation .... The assertion by the Human Rights Watch people that law enforcement engages in that kind of behavior is simply a lie.”

Lovell said the officers he represents support the state’s current system, but oppose making needles more accessible to the public at pharmacies because such an approach would lack adequate oversight.

“If you have this unfettered distribution, it’s really like putting pre-loaded syringes of polio or smallpox vaccine in a drugstore and telling people, ‘We have to fight polio or smallpox, go shoot up,” he said.