Twenty years ago, in 1986, I started injecting drugs. First it was cocaine, then heroin. Unbeknownst to me at that time, it had already been five years since public health officials first identified the disease we now call AIDS. My ignorance almost killed me.
And it was abetted by the media, which even now covers IV drug use-related AIDS as an afterthought, despite the fact that it drives the fastest growing epidemics in the world today and was almost entirely responsible for giving the virus a foothold in American minority communities. Though "down low" homosexuality has lately gotten media attention as a source of HIV transmission to heterosexuals, in fact, this has only become important as IV-drug use related AIDS declines.
In the 80's and 90's in New York (the IV drug use capital of the U.S.), 80% of heterosexual infections and a similar proportion of pediatric AIDS cases originated in infections acquired through IV drug use.
But activists pressed to educate addicts and to make clean needles available and saw remarkable success. In the 90's in New York city, 50% or more of the city's roughly 200,000 drug injectors were HIV positive. Today, the city estimates that only between 7 and 20% [pdf] are infected.
When I was injecting, so-called "addiction experts" claimed that addicts wouldn't protect themselves, that it was useless to provide clean needles or instructions on avoiding needle-sharing because addicts were always reckless and desperate. We were also supposed to be selfish pigs when it came to drugs-- but somehow simultaneously, peace- and-love hippies who enjoyed sharing needles as a "sub-cultural ritual."
Because I was shooting up myself, I knew that this wasn't true. The moment a health educator who happened to be visiting from San Francisco taught me about AIDS, I changed my behavior. I already avoided sharing when possible because it's icky (kind of like using someone else's tampon applicator) and because a fresh needle gives a better high because it's sharper.
After I learned about AIDS, the times I did share, I cleaned the needle with bleach extensively first. Though this has now been found not to eliminate HIV risk, it does dramatically reduce it-- and given how many addicts were infected in NYC when I was using, I do believe that outreach worker may have saved my life with her advice.
Tragically, however, the U.S. still bans federal funding for needle exchange and education programs-- and tries to prevent other nations and its own states from doing it. Research published in the Lancet suggested that 20,000 HIV infections in children, addicts' sex partners and addicts themselves could have been prevented with earlier and more widespread clean needle programs here.
Nonetheless, despite the fact that every scientific and academic body that has ever looked at the needle exchange research has concluded that clean needles save lives, despite the fact that clean needle programs are one of the best-supported practices in public health, the U.S. continues to oppose them. Even China and Iran are doing it now-- but America still places superstition higher than science.
And across the river from New York, New Jersey remains the one state in the union that bans even private organizations from carrying out needle exchange programs. In New Jersey, just under half of the state's infections (45%) are related to IV drug use, which is twice the national average. More than three-quarters of these cases are amongst ethnic minorities.
So, if you want to do something meaningful for World AIDS Day, give a New Jersey legislator a call or email and tell him or her to support Senate Bills 494 and 823 and their counterparts in the Assembly, Assembly Bills 1852 and 2839-- or donate to the Dogwood Center, which has done a great deal of important activism on this issue.
I managed to recover from my addiction-- but only because someone thought my life was worth saving before I was ready to stop using. How many others aren't being given that chance? And how can anyone think that it is "moral" to deny it to them?
Follow Maia Szalavitz on Twitter: www.twitter.com/maiasz