3 Years of Needle Exchange in Delaware: Saving Lives and Saving Dollars

The pilot Delaware Needle Exchange Program has had three very successful years. Over 700 people are enrolled, and over 38,654 needles have been exchanged. These potentially infectious syringes have been incinerated and destroyed. Not only have new infections been prevented, but participants have been successfully connected to substance abuse and HIV treatment services. Here are some more highlights, which we are also sharing with legislators today at the Joint Finance Committee budget hearings.

• 150 people have been referred to drug treatment, with an incredible follow up/success rate of 60%. Referrals have been made to methadone treatment, outpatient and inpatient drug treatment, and detoxification.


• Over 1200 people have been tested for HIV on the van. More than half were not needle exchange participants, but took advantage of the service being brought to their neighborhood. Testing has identified new HIV positive infections, as well as positives who know their status but are not in treatment. We are linking them to medical care and case management, which further reduces their risk of transmitting the virus.


• We have begun Pregnancy Screening on our van. Our goal is to reduce the infant mortality rate in Delaware by connecting drug abusing pregnant women to treatment immediately. This will ultimately save both the mother and the baby’s life. Delaware has an extremely successful record of preventing HIV infection among infants born to HIV infected mothers, with only one HIV-positive birth in the last 4 years. Expectant mothers with HIV in Delaware have access to comprehensive, high-quality care; yet, it remains imperative that we encourage them to be tested for HIV and to seek drug treatment.


• The needle exchange has made a difference for so many individuals in the past three years. Here is just one of those stories:
  
  "Cecilia" is a 24 year old Hispanic female who joined the needle exchange a little more than a year ago. She was an active drug user but was not ready for treatment. One day, after she had been with us about 6 months, Cecilia came on the van, tired and crying. She had finally had enough of the drug using lifestyle. We made her an appointment at the methadone clinic. She was having trouble signing up for Medicaid to handle her payments, so we helped her with that, and she was successfully admitted. At time of admission, she had a pregnancy test and found out she was 4 months pregnant. She stayed in treatment and gave birth to a healthy baby. Today Cecilia is still active in treatment and is also employed.


• Lastly, we would like to share with you the cost benefit of needle exchange. Delaware’s program receives $211,000 from the Division of Public Health each year. We know from a recent CDC study that preventing one new HIV infection saves $221,365 in treatment costs. So, the prevention of one new HIV infection pays for the Needle Exchange Program for one year. In three years, Delaware’s needle exchange has prevented an estimated 10-12 new infections by connecting nearly 20 people to HIV care. Therefore, we saved an estimated $2 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.

The success of the needle exchange is thanks to the inclusive and considerate work of our program staff at Brandywine Counseling, along with incredible support from the City of Wilmington, neighborhood associations, the Faith Community, the Division of Public Health and the Wilmington Police. This is an excellent example of what can happen when a community mobilizes.

We must keep up the work we’re doing. This epidemic remains a challenge, but we are making progress. 3,489 people are living with HIV/AIDS in Delaware. The Black community accounts for 20.9% of the state’s population, but 66% of our HIV/AIDS cases. While the number of new infections each year has declined, in Delaware, 1 in every 83 Blacks has HIV/AIDS.

Delaware’s Needle Exchange remains dedicated to the following goals:

• We must encourage HIV testing for all those who are at risk.
• We must encourage all of those that are infected to seek treatment.
• We must encourage those not infected to take measures to ensure they remain uninfected. Until then, many will continue to pass the virus without knowing it.