Basha Silverman's Testimony at State Budget Hearings

My name is Basha Silverman. I am the Director of HIV Prevention programming at Brandywine Counseling in Wilmington. I am here to call your attention to the importance of the Needle Exchange Program on behalf of the Division of Public Health and the many individuals at risk of contracting HIV in Delaware. I understand you have some very difficult decisions to make this year, so I wanted to arm you with some information that may help you.

The Needle Exchange program does not only provide access to sterile equipment; it is a bridge to other services.

• In just 2 years, this mobile program has been extremely successful at identifying at-risk and HIV-infected individuals, and connecting them to medical care and substance abuse treatment.


• We are reaching a very, very hard to reach population that might not receive or follow through with services if the services were not brought to them.


• We have tested over 900 individuals on the van.


• To date, we have identified approximately 20 HIV positive individuals, and linked them to HIV treatment and case management.


• Additionally, we have successfully linked 62% of those ready for substance abuse treatment to a treatment center.


• Almost 40% of participants are women. When we connect a woman to treatment, especially a pregnant woman, we increase her chance of giving birth not only to a healthy baby, but one that is not HIV infected.

Why Needle Exchange?

• In Delaware, it took over a 10 year battle to pass such a significant piece of legislation.


• In the late 80s, methadone treatment was our best intervention known to combat HIV/AIDS. Today, needle exchange is the most widely studied and has proven to be most effective intervention to combat the spread of HIV.


• Needle exchange is not just HIV prevention, it is pre-treatment.


• Studies also show that once a person learns they are HIV positive, they are approximately 60% less likely to infect another person. Therefore, the testing efforts on our van are unquestionably a significant service that should not be cut.


• Lastly, just a reminder of the cost benefit. The needle exchange program costs roughly $200,000 a year to provide services on the van and make linkages to other services and programs designed to increase the overall health of Delawareans. In comparison, the estimated cost to treat ONE individual infected with HIV over their lifetime ranges from $300,000 to $600,000, depending on how long he or she lives. In two years, we prevented an estimated 10-12 new infections by connecting nearly 20 people to HIV care. Therefore, for $200,000, we saved an estimated $3 million that would have been spent on treating those individuals - and that is a modest approximation that does not include the infections prevented when someone is admitted to substance abuse treatment.

Thank you for listening. Thank you Senator Henry!