Community Board 12 took its first public step toward bringing a needle exchange program to Jamaica last week by inviting health experts to present data on the problem of and possible solutions to the area’s HIV/AIDS crisis.
Dr. Marjorie Hill, the assistant commissioner of the Department of Health and Mental Hygiene Bureau of HIV/AIDS, gave a detailed presentation of the agency’s data on the disease and the effectiveness of syringe exchange programs, but emphasized that the program’s details must be decided by the community.
“The state will not consider an application unless it is supported by the community and community board,” Dr. Hill said, emphasizing that the board members’ approval is “more than just a rubber stamp.”
Because the hours, location and type of program must be decided by the area residents, not program providers, the two proposals presented by the AIDS Center of Queens County and the Queens Hospital Center were necessarily short on details.
But both began with the same recognition, based on data from the Health Department, that Southeast Queens residents are becoming infected with the HIV virus through intravenous drug use at a rate that constitutes a public health crisis.
“New York City has the largest HIV/AIDS epidemic in the United States,” Dr. Hill said, pointing out that the city received a record $122 million from the government last year to combat the disease. “And intravenous drug use is a driving force in the epidemic.”
In Jamaica, the Health Department tracked 201 people diagnosed with the HIV virus in the last year and 1,706 people living with HIV/AIDS. It estimates that 500 intravenous drug users live in the area, but, Dr. Hill qualified, “these numbers are very conservative because not everyone who is HIV positive goes to be tested and many people are not ‘out’ about their drug use.”
Since 1992, the state has licensed needle exchange programs in specific hotspots of infection through shared needles. However, despite a proven need in the Rockaways, Jamaica and certain western neighborhoods, neither Queens nor Staten Island has ever had a needle exchange program. Community Board 2 recently approved one for the Queensbridge area of Long Island City, but it has yet to be implemented.
“Syringe exchange programs do work,” Hill said, pointing to statistics showing that in 1991, 50 percent of all intravenous drug users were infected with the virus, while by 2002 only 12.5 percent were infected.
However, she admitted that “this is a very challenging constituency to work with,” and urged the board members to design a program that they could be comfortable with.
Board member Tracey Bowes was concerned about the program attracting drug users to the area. “If I lived in the Bronx, is there anything to prevent me from going to Queens for a syringe exchange program?” she asked.
“I believe it would be a violation of state law for a health care provider to refuse service based on residence,” Dr. Hill replied, “but drug users don’t go looking for syringes. They go looking for drugs.”
Ruth DuBerry, a member of the board’s Health Committee, asked who would be monitoring the proposed programs. Dr. Hill replied that the state, which issues the waivers to allow the programs to open, would be monitoring them closely.
Dr. Mark Johnson, a board member of ACQC, then gave a presentation of his organization’s proposal to create a community-based syringe exchange program in an as-yet-undetermined location in Jamaica.
“Most of HIV right now is in people of color,” Dr. Johnson said, citing figures that between 80 and 85 percent of new infections are African-American and Latino.
As a community-based, “one-stop-shop” that has been offering legal services, case management, medical care, housing help, harm reduction and a food pantry to people with HIV/AIDS in Queens for over 18 years, ACQC is intimately familiar with this population and qualified to run a needle exchange program in the community, Dr. Johnson argued.
Lorinda Sherwood presented Queens Hospital Center’s proposal for a medically-based needle exchange program at its Drew Center on Archer Avenue, which would become a new behavioral health center.
“It would be much more than a needle exchange,” Sherwood said. “We see it as a gateway to mental and medical health services.”
The program would have a nurse practitioner on staff, as well as peer counselors and outreach workers, and try to create a comfortable environment where the clients would feel at home.
Clients would come into the center, begin by filling out paperwork to determine eligibility, go over the available services with staff and finally exchange used needles for free clean ones. Participation will be anonymous and clients will carry identification cards with them at all times.
Bowes questions why the hospital decided to propose the program at the Drew Center in Jamaica, as opposed to Queens Hospital Center’s main building in Community Board 8.
Councilman Leroy Comrie of Jamaica supported both programs, saying, “We have a real problem in Southeast Queens. We need to be more vocal about what is going on in our community.”
He liked the proposed Drew Center location because it is a high-traffic area, which would make the clients more anonymous and prevent them from being able to go around a corner to shoot up.
The proposals will be discussed further when the community board meets again in September.