AIDS Warning for Junkies : County to Put Safety Message for Needle Users Out on the Streets

Fearing a surge in AIDS cases among intravenous drug users, San Diego County health authorities have begun training recovering addicts to go out to clinics, jails and the streets to educate drug users about the risk of infection from dirty needles.

About a dozen men and women referred through drug-treatment programs and trained this week by the county Department of Health Services are to begin work in early March in an effort to stem the spread of the fatal infection among the thousands of intravenous drug users in the county.

The pilot project, modeled on an 8-month-old San Francisco program in which ex-addicts distribute information as well as bleach for disinfecting needles, is aimed at averting the kind of increase in AIDS among drug users that has occurred on the East Coast.

“We are anticipating that if we follow the same pattern as the East Coast, we will probably also be having a surge of (drug users) getting AIDS,” said Patricia Riddle, a county public health educator. “ . . . We are hoping to prevent that.”

The AIDS virus attacks the body’s immune system, leaving the victim vulnerable to a variety of infections and tumors. It is transmitted by sexual contact, by contaminated needles and blood, and from an infected mother to her newborn. As of Monday, 31,036 Americans had developed AIDS and 17,851 had died, according to the federal Centers for Disease Control.

So far, about 8% of the 405 reported cases of AIDS in San Diego County have involved drug users or homosexuals and bisexuals who use drugs, said Dr. Michelle Ginsberg, county epidemiologist. The comparable national figure is 25%.

But recent figures on infection rates among drug users turning up for AIDS testing at county clinics are significant, she said. She said 18% of the drug users tested between June, 1985, and June, 1986, were found to have been exposed to the virus.

Although only a fraction of those exposed to the virus have come down with the disease, public health officials are concerned that infected drug users are spreading the disease into the heterosexual population through sexual contact.

“We have to take advantage of the fact that we have not yet seen the 25% as in the nation as a whole,” Ginsberg said. “We have to try and introduce risk reduction and the concept of avoiding intravenous drug use before that infection occurs.”

The county’s new counselors are to carry a multiple message.

First, they are to encourage drug users to get off drugs, not only because needles can transmit the AIDS virus but because drug abuse weakens the immune system and increases susceptibility to many types of infection.

“The second message is, ‘If you use drugs, don’t inject,’ ” said Riddle. “Third, if you do inject, don’t share needles.” And fourth, “if you are going to share ‘works,’ be sure to clean and soak the works. We hope that will be enough to deactivate the virus.”

Finally, the counselors will encourage intravenous drug users to use condoms to protect themselves and their partners from transmission of AIDS through sex. They will also encourage them to submit to confidential testing for the AIDS antibody at one of four county-run clinics.

Initially, the counselors will go to places with large concentrations of drug users, such as methadone clinics, drug-treatment programs and county jails, if possible, officials said. Later, they will try one-to-one counseling on the streets and in target communities.

All of the counselors are expected to have had some previous experience as “peer educators” in drug programs. They are receiving 12 hours of training this week from the county Department of Health Services.

The program, funded through June by a $10,000 state grant, is modelled on a similar program run by the Haight-Ashbury Free Medical Clinic in San Francisco. John Newmeyer, the clinic’s epidemiologist, said that program followed the first addict-education program in New Jersey.

County health officials in Los Angeles said they have no similar program.

In San Francisco, Newmeyer said, seven “street-wise people, some of them ex-users” have been educating drug users about AIDS over the last eight months. They also distribute condoms and small bottles of bleach, which is believed to be able to disinfect needles.

“We found that people are changing their habits,” Newmeyer said Tuesday. “Not so much with sex, with the condoms, but much more with the bleach because that’s a relatively simple addition to their life style.”

Riddle said her department in San Diego opted against distributing bleach because it has not yet been proven in tests to eradicate the virus.

“We’re looking for something scientifically sound and something they will do,” she said. “We’re trying to blend art and science and an understanding of human nature.”

In San Francisco, where Newmeyer estimated there could be 12,000 intravenous drug users, the counselors are working full-time at a cost of about $25,000 per counselor to cover salary and supplies.

There are no accurate figures on the number of intravenous drug users in San Diego County.

However, county drug program administrator Melinda Newman said officials estimate that there are 21,000 heroin addicts alone. In addition, she said cocaine and methamphetamine users are now injecting those drugs intravenously.

Last year, 1,108 drug users were treated in county-funded programs, 4,181 received crisis counseling and 6,386 received methadone services, county officials said.

The counselors will begin working only about four hours a week each. But Joan Friedenberg, chief of public health education for the county, said she hopes to secure an additional $40,000 grant in June to continue and expand the program.