San Diego’s Clean Syringe Exchange Pilot Program, which was launched in July 2002 to help combat rising hepatitis C infection rates and the HIV/AIDS epidemic in the city, may re-launch this year after a seven-month hiatus.

The program was put on hold last July following a non-majority San Diego City Council vote that was caused by the resignations of Councilmembers Michael Zucchet and Ralph Inzunza. The resignations of the two men, who had consistently voted in favor of the program, resulted in a final 4-2 vote in favor of the syringe exchange program. But because five council votes are needed to approve any measure, the syringe exchange program was temporarily shelved.

With an anticipated majority council vote now that Zucchet and Inzunza’s seats are filled and Mayor Jerry Sanders’ support of the program, needle exchange proponents expect the program to re-launch in San Diego in the next few months.

Assembly Bill 136, which took effect Jan. 1, 2000, decriminalized needle exchange programs operated by public entities if the city or county declares a local health emergency. The San Diego City Council first declared a local health emergency in October 2000 in response to the rapid spread of hepatitis C and HIV through the shared use of needles and syringes, joining 20 other California jurisdictions that have done the same. The council continued to declare a local health emergency every two weeks in accordance with state law.

Last year, Gov. Arnold Schwarzenegger signed Assembly Bill 547, which eliminates a section of state law requiring cities and counties to declare a health emergency every two weeks to justify continuing needle exchange programs. The law, which took effect this year on Jan. 1, makes it easier for cities and counties to maintain needle exchange programs to combat the spread of HIV/AIDS and hepatitis C. Under the provisions of AB 547, local governments will hold hearings once a year prior to reauthorizing the programs.

Alliance Healthcare Foundation and the California Endowment provided private funding through their Harm Reduction Funding Initiative to launch the Clean Syringe Exchange Pilot Program. In April 2002, Family Health Centers of San Diego was chosen from a pool of applicants to implement program services, and was awarded a $367,000 contract with Alliance Healthcare Foundation for a one-year pilot program.

In July 2002, the Clean Syringe Exchange Pilot Program launched in downtown’s East Village, operating from a mobile unit one night a week for a three-hour period. A second mobile-unit site, also open one day a week for a three-hour period, opened in North Park in February 2003. A third program site was proposed for City Heights but was abandoned because of time and funding restraints.

After a presentation is made to Mayor Sanders, the needle exchange program proposal will be placed on the council docket for an approval and vote, said Adrian Kwiatkowski, a lobbyist with The Monger Group, which represents Alliance Healthcare Foundation.

City Council president Scott Peters, who has already reviewed the presentation, said he would bring the needle exchange initiative to council after Sanders has had a chance to get up to speed on the issue, according to Peters’ communications director, Pam Hardy. Hardy said Peters is committed to bringing the needle exchange program to council, and supports it as an important public health program.

Sanders’ communications director, Fred Sainz, said Sanders supports the concept of needle exchange, but has not yet met with Alliance Healthcare Foundation to work out the details of establishing another program in San Diego, and plans to meet with Alliance Healthcare within the next month.

Councilmembers Brian Maienschein and Jim Madaffer have consistently voted against needle exchange since 2002, as did former Mayor Dick Murphy.

Maienschein and Madaffer’s offices did not return calls placed by the Gay & Lesbian Times seeking comment as of press time.

County Board of Supervisors vice-chair Ron Roberts supports a needle exchange program in San Diego, but only if it’s tied to mandatory substance abuse treatment, said Roberts’ chief of staff, Darren Pudgil.

According to a utilization report compiled by Family Health Centers of San Diego, 353,878 used syringes were received and 290,642 clean ones distributed between July 2002 and July 2005. The report also documented a total of 627 assisted referrals to detoxification, with 438 people put directly into treatment.

“That’s a really high number. I don’t know if any other program has figures to these levels for helping people get into treatment and detox,” said Linda Lloyd, Alliance Healthcare Foundation vice president of programs, who also served on the Clean Syringe Exchange Task Force, which helped launch the program, and currently serves on the Clean Syringe Program Facilitation Committee. “They can say they gave referrals, but they don’t know those people got into the program. Here, they can say ‘We saw them walk in the front door.’”

Lloyd said everyone who utilizes the syringe exchange program is offered a treatment referral by Family Health Centers staff.

“If someone says they’re interested in it, they [Family Health Centers staff] immediately make a phone call to a treatment provider – and they have very good working relationships with the ones who would be most convenient,” Lloyd said. “They can get people into treatment very quickly. They’ve had a great response, so I think people are getting into treatment when they want it.”

District 3 Councilmember Toni Atkins has been a strong supporter of needle exchange programs, and said she was encouraged by the number of referrals to drug rehabilitation, shelter, food, medical care, STD testing and employment services that were generated because of the San Diego program. The utilization report documented a cumulative total of 7,152 referrals from the East Village and North Park mobile-unit sites.

“I think it’s important to reinstate the clean-syringe exchange program, and it’s my goal to have the program back up and fully running again as soon as possible,” Atkins said. “I believe in its mission, and I’m satisfied that the data supports the goals put forth by the program’s proponents.”

Atkins said the amount of needles collected at the North Park site – over 140,000 dirty needles have been disposed of at that site since the program began – has made the city a safer place.

“Although it’s difficult to measure a quantifiable impact on the overall regional health crisis based on the two sites – North Park and downtown – the results I’ve seen tell me that I should continue to support the program,” she said.

Dr. James Dunford, director of the city of San Diego’s Emergency Medical Services and a professor of emergency medicine at UCSD, who also chairs the Clean Syringe Exchange Program Facilitation Committee, said he felt it was important to promote a public health issue.

“On a daily basis, I was seeing needle sticks by health care workers. Sometimes they were paramedics and sometimes they were firefighters and nurses in the hospital,” Dunford said. “I wanted to say something from a public policy point of view, that it was important to endorse this pilot syringe exchange program.”

On a national scale, the U.S. Surgeon General, the Centers for Disease Control and Prevention, the National Institutes of Health and the American Medical Association all approve of clean-syringe exchange programs.

Since the AIDS epidemic began, according to the National Institute on Drug Abuse, injection drug use has directly and indirectly accounted for more than one-third (36 percent) of AIDS cases in the United States, and, in 2002, an estimated 28 percent of diagnosed AIDS cases among adults and adolescents were related to injection drug use.

According to a CDC analysis of HIV surveillance data, 25 percent of cumulative AIDS cases reported through December 2002 were among intravenous drug users.