Declaring a citywide emergency, Mayor Frank Jordan defied California law Monday and announced that San Francisco will give clean needles to drug users in a campaign to halt the spread of AIDS.
With Jordan’s action, San Francisco will become the first city in California to provide public funds for a needle exchange program and flout a state law banning the distribution of hypodermic needles without a prescription.
Jordan said the efforts of underground groups operating outside the law have demonstrated that trading clean needles for dirty ones can markedly reduce the spread of AIDS. In San Francisco, a 4-year-old volunteer needle exchange program has become so successful it has run out of private funds and would have shut down Monday without help from the city, he said.
“We want to do everything we possibly can in San Francisco to reduce the threat of AIDS,” Jordan said. “In order to operate needle exchange legally, we must declare a local state of emergency.”
Kassy Perry, spokeswoman for Gov. Pete Wilson, said the governor’s legal staff is looking into whether San Francisco has the authority to override state law by enacting a state of emergency.
“There is some evidence that the declaration of a state of emergency does not supersede state law,” she said.
Last year, Wilson vetoed legislation backed by San Francisco and AIDS activists that would have made a needle exchange program legal.
The governor and other opponents of the exchange program argue that passing out needles and syringes on the street encourages intravenous drug use and undermines law enforcement agencies. The governor also contends that the effectiveness of needle exchange programs in slowing AIDS is unproven.
Underground needle exchange programs operate illegally in at least a dozen California cities, including Los Angeles and San Diego. In many locations, police look the other way.
In San Francisco, where it has long had the support of the mayor’s office, the all-volunteer Prevention Point distributes an average of 16,000 needles a week.
Since the program began, city health officials point out that the rate of HIV infection among drug users has not risen. In New Haven, Conn., a study by Yale University researchers showed that a similar syringe exchange program resulted in a 33% reduction in the rate of new HIV infections.
“The evidence is overwhelming that syringe exchange reduces needle sharing and transmission of HIV among intravenous drug users,” said Raymond Baxter, director of the San Francisco Health Department. “San Francisco is doing the right thing by providing direct financial and programmatic support to a needle exchange program.”
Jordan, widely regarded here as a weak mayor, won praise from AIDS activists for his declaration of emergency.
“The result of today’s action is clear: Thousands of lives will be saved,” said Pat Christen, executive director of the San Francisco AIDS Foundation.
More than 10,000 people have died of AIDS in San Francisco and more than 30,000 people are HIV-positive--a rate of more than one in 25 residents.
Sharing of contaminated needles has been a major cause of the spread of the disease, said Baxter, the health director, noting that half of the 300 women with AIDS in San Francisco are intravenous drug users. And, he said, virtually all children born HIV-positive in the city have been linked to transmission of the disease through drug use.
Prevention Point attempts to reach the 16,000 intravenous drug users by delivering sterile needles, bleach, condoms and other anti-AIDS paraphernalia to six locations on a weekly schedule. The group distributes about 15,000 to 20,000 needles a week, the most of any needle exchange program in the state.
In Los Angeles, where the concept of needle exchange has won far less support from elected officials, a group called Clean Needles Now has begun distributing about 2,000 needles a week. By contrast, Los Angeles County has an estimated population of as many as 220,000 intravenous drug users.
Renee Edgington, a leader in the Los Angeles effort, praised Jordan for finding a way to get around the state prohibition and devote public money to a needle exchange program.
“I think this is a model for Los Angeles to follow,” said Edgington, who was on hand for Jordan’s announcement.
After Jordan’s announcement, the San Francisco Board of Supervisors ratified the declaration of emergency. To keep the program alive, the board must renew the declaration every 14 days. Today, the Health Commission is expected to approve a $138,000 contract with Prevention Point to distribute the needles.