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Giving New Life to New Jersey Syringe Access Programs

I had the honor to help develop the first legal syringe access program (SAP) in Atlantic City, NJ, almost 10 years ago. In 2006, the New Jersey legislature passed the Blood-Borne Disease Harm Reduction Act. This allowed for the establishment of up to six pilot SAPs in NJ. However, approval from each selected city’s government was required before opening. Working with Drug Policy Alliance and the Division of HIV, STD and TB Services (DHSTS) located within the Public Health Services Branch of the Department of Health (DOH), five municipalities were subsequently authorized to operate SAPs:  Atlantic City (11/7/07), Camden (1/5/08), Paterson (1/30/08), Newark (2/19/08), and Jersey City (7/6/09).  In August 2016, NJ Governor Christie authorized a law that allows any municipality in the state to open a SAP. One recently opened in Asbury Park and another will be opening very soon in Trenton. Before the end of the year, there will be a total of seven SAPs operating across the state of NJ.

According to the DHSTS (as of 12/31/16), >37,000 people are living with HIV in NJ, and 34% of those infected reported acquiring HIV through injection drug use (IDU). Cumulatively, IDU and sexual contact remain the major modes of HIV transmission.[1] Since the start of SAPs in NJ, the proportion of reported HIV cases with exposure through IDU has decreased, but acute hepatitis C virus (HCV) cases in NJ continue to rise. From 2011-2015, reported rates of acute HCV have increased by 150%.[2]

Governor Christie has acknowledged the importance of SAPs and recent legislation has provided additional funding to support these services at a critical time. The motivation for this legislation is largely in response to the increase in drug overdoses, which is now the leading cause of unintentional death in NJ.[3] A series of acts was authorized to protect people with a substance use disorder as well as those who may be trying to help them, from certain liabilities regarding and during drug-related incidents. Most recently a NJ state bill was signed into law which expands access to naloxone by making it available without a prescription in more pharmacies across the state. While the focus of this legislation may not directly be the elimination of HIV or HCV, it has helped to extend the life of NJ’s SAPs which can subsequently help reduce incidence rates in the state.

Over the last 10 years, the South Jersey AIDS Alliance in Atlantic City has provided services to almost 24,000 people. Our services not only include distribution of clean needles and injection equipment, and the disposal of these items; but also, pregnancy, HIV, HCV and STI testing; and, referrals to drug treatment, healthcare, and other basic need assistance.  Each of the five sites is fortunate enough to have an Access to Reproductive Care and HIV Services (ARCH) nurse available to meet clients where they are, physically and mentally. They are a breath of fresh air for so many of our clients who are accustomed to feeling stigmatized wherever they seek medical services, because of their addiction.  SAPs are a cohesive group; every day we connect with people who are struggling and we can assure them we are here to help.  With sustained funding and support, we are positioned to help address increasing HCV infection rates, linkage of people living with HIV to ongoing health care, and the increase in substance use in our community.