'Epidemiology and The Politics of Needle Exchange'

Needle exchange programs are commonly used in HIV transmission reduction by giving intravenous drug users the opportunity to trade their used needles and other injection tools for sterile ones. While this harm reduction measure has proven as effective in many regions, in 1997 a study conducted in Montreal actually insisted the opposite, claiming elevated risks for infection associated with attendance of needle exchange programs were significant (Bruneau et al., 1997). In A.R. Moss’ article Epidemiology and the Politics of Needle Exchange, he asserts his position as an epidemiologist and someone who actively works with drug users. He shares his perspective on why he believes this is an intervention that has no reason not to work, and demands an explanation for why it did not, the implications, and what should be done about it. He highlights how, due to the contribution this Canadian study has made to the dent that has been made in the notion of needle exchange programs being effective, it has created a polarized debate within public health circles. He goes on to explain one of the primary reasons why he believes this debate came to be so contradictory, saying “the first answer is that the needle exchange issue was promoted very rapidly into the political process—maybe somewhat prematurely from the research point of view, but advocates would argue that there was an overwhelming public health need for action.” (Moss, 2000, p. 1385) What makes this article noteworthy, and why it so pertinent in creating a timeline focusing on politics/rights concerning HIV, is due to how the author identifies the political process and decision making as the main force in influencing the prospective research and data on needle exchange programs. 

References

Bruneau, J., Lamothe, F., Franco, E., Lachance, N., Desy, M., Soto, J., & Vincelette, J. (1997). High Rates of HIV Infection among Injection Drug Users Participating in Needle Exchange Programs in Montreal: Results of a Cohort Study. American Journal of Epidemiology, 146(12), 994–1002. https://doi.org/10.1093/oxfordjournals.aje.a009240

Moss, A. R. (2000). Epidemiology and the politics of needle exchange. American Journal of Public Health, 90(9), 1385–1387. https://doi.org/10.2105/ajph.90.9.1385