Why do we need harm reduction in North Carolina?

 

North Carolina in Context

The South is at the epicenter of the HIV epidemic in the United States, with more people living with HIV and dying of AIDS than in any region in the country. The South has the highest rates of new infections, the most AIDS deaths, and the largest numbers of adults and adolescents living with HIV/AIDS. In many states in the South, socio-economic conditions combine with state laws and policies to undermine human rights and create an environment where the risk of acquiring, transmitting, and dying of HIV/AIDS is higher than anywhere else in the country.

 

HIV/AIDS

 

HIV is most commonly spread through engaging in unprotected sex and sharing injection equipment. In North Carolina an estimated 35,000 people are living with HIV/AIDS. The rate of new HIV infections in the state is 41 percent higher than the national rate. Nearly one in three people newly diagnosed with an HIV infection in North Carolina already have AIDS, the last stage of the disease, indicating that people are not seeking testing or care until they are very sick. As a result of late testing and delayed treatment, the death rate from HIV disease in North Carolina is 10 percent higher than the national average.


HIV/AIDS has a disproportionate impact on minority communities in North Carolina. The rate of HIV infection for non-Hispanic blacks is nine times greater than the rate among whites, and the rate for Hispanics is four times that of whites. Two-thirds (66.5 percent) of all people diagnosed with AIDS in North Carolina are African-American. An estimated 50,000 injection drug users live in North Carolina. Since the beginning of the epidemic in the early 1980s, more than one in five people with AIDS in North Carolina acquired the disease through injection drug use, one of the highest percentages in the country.


This information is from the Human Rights Watch’s article: ”We Know What to Do, Harm Reduction and Human Rights in North Carolina,” with permission by Human Rights Watch.

 

Injection Drug Use Map
Source: Kaiser Family Foundation, State Health Facts, 2009

 

Estimated Numbers of AIDS Diagnoses Among Adults and Adolescents, by Transmission Category, Cumulative 1981 through 2009

New HIV infections resulting from injection drug use have declined in recent years. Notwithstanding, in North Carolina, 4 percent of all new HIV cases diagnosed in 2009 were attributed to injection drug use (including men who have sex with men who also inject drugs). Yet any new case of HIV resulting from injection drug use is preventable, at little or no cost, and sterile syringe access can significantly reduce the risk of HIV trans- mission between injection drug users. Sterile syringe programs have proven for decades to reduce the risk of HIV transmission among injection drug users, and contributed to the 80 percent drop in HIV transmission from injection drug use since the beginning of the epidemic in the United States. A New York study showed that HIV prevalence fell from 54 to 13 percent among injection drug users following introduction of syringe distribution programs. We know what to do.


Yet any new case of HIV resulting from injection drug use is preventable at little or no cost, and sterile syringe access can significantly reduce the risk of HIV transmission between injection drug users. Sterile syringe programs have proven for decades to reduce the risk of HIV transmission among injection drug users and contributed to the 80 percent drop in HIV transmission from injection drug use since the beginning of the epidemic in the United States. A New York study showed that HIV prevalence fell from 54 to 13 percent among injection drug users after intro- duction of syringe distribution programs.


North Carolina law permits syringe purchase at pharmacies, but it is a class A misdemeanor to possess or distribute syringes or other parapher- nalia that may be used for injection of illegal substances. This means that people who use drugs and outreach workers face criminal sanctions for taking lifesaving measures to prevent HIV. In 2008 there were nearly 2,000 arrests for illegal possession of drug paraphernalia. Though not all of these involved syringes, a 2009 study found that fear of arrest was a likely factor in reducing purchase of syringes in pharmacies, particularly among African-Americans.