"Take the Test, Take Control." So says the mandate of National HIV Testing Day (NHTD). And indeed, who better to control my health than me? But not everyone has that privilege. The ban on federal funds for syringe services programs (SSPs) wrests control from injection drug users -- an abject failure of government to support evidence-based public health, and a rejection of the domestic and global goal of an AIDS-free generation.
Eliminating "risky behavior" is impossible. Risk will always exist -- by choice, circumstance, or more complicated trajectories -- so we create interventions and services that mitigate negative consequences for our health. We all deserve those services, even if -- in fact, especially when -- we are unable to live perfectly healthy lives. We must finally allow science to guide policy, treat injection drug use as the health issue it is, and lift the ban on syringe exchange funding.
Aside from a brief window from 2009-2011, Congress has maintained a blanket ban on states using federal funding for SSPs. The ban is maintained despite decades of research proving syringe exchange to be one of the most effective HIV prevention interventions to date:
· providing HIV testing, hepatitis C screening, and referrals to health care and drug treatment to people who are often otherwise denied service.
· safely disposing of used syringes, so they don't litter parks or accidentally stick police.
· addressing health disparities affecting communities of color.
· not encouraging drug use; on the contrary, benefiting communities and in some cases reducing crime.
Despite the fact that lifting the ban would save hundreds of thousands of dollars for each HIV infection prevented, costing nothing to implement because it simply allows for local control of existing funds.
Such extensive research offers overwhelming practical grounds for lifting the ban, but I'll add another: because it is right. Yes, there are negative consequences of drug use. But denying others the ability to take steps toward better health, in a respectful and compassionate environment, is wrong.
This National HIV Testing Day, 81 community-based organizations, and 62 national organizations, are sending a letter to House and Senate appropriations committee leadership reiterating that maintaining this ban is wrong. We remind Senators Mikulski and Harkin, and Representatives Rodgers and Kingston, that when claiming to care about the health of our citizens, our neighbors and children, our friends and lovers, we must care about the health of them all.
Preventing disease, linking to services, protecting children and law enforcement, saving money, reducing health disparities and crime -- these are all good, practical goals. But we should be more than good. We should be right. We should be just.
Treating others with dignity, respect, and compassion -- that is right. Prioritizing all life, regardless of whether you agree with another's choices -- that is right. Allowing all people the means to control their health -- that is right.
Lifting the ban on federal funding for syringe exchange as a means to those ends -- that is just.