As we commemorate World AIDS Day today, we need to remind ourselves that today is more than remembrances and reflections. As we look back to honor those who have died, we should also look forward and take action to prevent more needless deaths. World AIDS Day is a call to do better.
We have made huge progress in the fight against HIV/AIDS, but on this World AIDS Day, I can’t help thinking about how much more we can and should be doing, especially to help people who use drugs. The criminalization and mass incarceration of people who use illicit drugs, along with policies that restrict access to sterile syringes and opioid maintenance therapies (such as methadone and Suboxone), have facilitated the spread of HIV/AIDS, not to mention other blood borne diseases, such as hepatitis C.
A 2012 report by the Global Commission on Drug Policy reviewed the research and concluded that repressive drug law enforcement keeps people who use drugs away from public health services, pushes them into hidden environments where HIV risk is elevated, and creates barriers to getting care and treatment. According to the CDC, since the epidemic began, nearly 186,728 people who acquired HIV through injecting drugs have died in the U.S. And while, new infections among those who inject drugs have declined, seven percent of all new HIV infections in the U.S. are still among people who inject drugs, and another three percent are among people who had male-to-male sexual contact and used injection drugs. These statistics represent thousands of new HIV cases that could be prevented.
According to the Global Commission, countries that have adopted evidence-based public health and drug policy strategies have seen their HIV epidemics among people who use drugs dramatically decline. One research-based and life-saving intervention that the U.S. should immediately import from our global neighbors are supervised injection facilities (SIFs).
SIFs are health care settings where people can more safely inject drugs under clinical supervision. Also called safer injection sites, drug consumption rooms, and supervised injecting centers, SIFs are designed to reduce the health and public injection by providing a space for people to inject pre-obtained drugs in a clean environment with access to sterile injecting equipment and under the supervision of trained medical staff. SIFs can also be an important entry point for people, who can be hard to engage in services, to access needed counseling and referrals to health and social services, including drug treatment.
There are at least 98 SIFs operating in 66 cities around the world in countries ranging from Switzerland and Greece to Australia and Canada. SIFs have been rigorously studied and found to result in a host of positive public health outcomes, including reducing overdose deaths and improperly discarded injection equipment, increasing public order and access to drug treatment and other services, and saving taxpayer money. And critically, SIFs have been found to attract injection drug users most at risk for HIV/AIDS and to reduce HIV/AIDS risk behaviors by decreasing risky injection practices, providing clean injection equipment, and providing prevention education.
Despite their life-saving potential, there is not one legally sanctioned SIF operating anywhere in the U.S. This World AIDS Day, let’s remember that we can’t end HIV/AIDS until we end the war on drugs. And let’s start with a proven, commonsense solution that we know works. It is time for the U.S. to start opening a supervised injection facility.
We can do more, and we must.
Julie Netherland is the director of the office of academic engagement at the Drug Policy Alliance.