In its new policy statement, the American Academy of Pediatrics (AAP) has urged pediatricians to voice their support for the needle exchange program, a program where used syringes are exchanged for new clean ones, to bring down the instances of HIV infection among drug addicts.
The group has also asked its members to take a 'nonjudgmental approach' while discussing the risk of HIV infection with teenagers and also extend other help if possible.
“If we can help young people avoid a chronic illness that we have no cure for, I would hope people would embrace that idea,” said Dr Lisa Henry-Reid of John H Stroger Jr Hospital in Chicago, who headed the committee that drafted the new AAP policy statement.
According to the new statement, needle exchange programs can reduce the instances of HIV infection through infected needles. “Injection drug users, men who have sex with men and engage in injection drug use, and heterosexuals who have sexual contact with an injection drug user were responsible for 23 per cent of reported AIDS cases among adults and adolescents in 2003. Among youth 13 to 24 years of age, these transmission categories accounted for 13.4 per cent of AIDS cases in 2003,” the statement said.
According to committee member Dr Peter Havens of the Medical College of Wisconsin, such programs, coupled with counseling can go a long way in combating risky sexual behavior among drug addicts.
But Concerned Women for America president Wendy Wright felt that such programs only encourage drug use. “The recommendation will not rescue patients and neither does it promote healthy behavior. Instead, they have been promoting programs that encourage riskier activities,” she said.
Rubbishing claims of increased drug abuse due to needle exchanges, the statement said, “Pediatricians should advocate for unencumbered access to sterile syringes and improved knowledge about decontamination of injection equipment.”
Even though the Congress has refused to fund needle exchange programs, 36 states and the District of Columbia continue to offer clean needles in exchange for dirty ones. The Centers for Disease Control and Prevention (CDC) has also supported the AAP's assertion that the programs cut the spread of HIV without increasing the instances of drug addiction.
Besides creating awareness about the ills of drug abuse, the AAP also recommended that pediatricians support frank discussion between youngsters and their families to avoid the initiation of drug, alcohol and tobacco use, and lobby for 'youth-friendly substance-abuse treatment facilities' that can accommodate uninsured, underinsured, and undocumented youths as well. “Engagement of a youth in his or her own health care is critical to achieving a physician-patient relationship in which honest discussions about high-risk behavior are possible.
Pediatricians should review their state laws governing health care services available to minors without parental consent. Confidentiality policies should be developed and discussed with both the youth and parent present,” the statement said.
According to Henry-Reid, around 50 per cent of all new HIV infections involve those younger than the age of 25 years and such measures can help cut risky behavior to a major extent.
