Some programs in Washington D.C. are not working because of lack of funding. Although D.C. has the highest AIDS rate in the country, there is not enough support coming from its community to help the prevention of AIDS. Total costs of the program, namely production, storage and distribution as well as management, are estimated getting a cost figure per sterile syringe distributed. Effectiveness, defined as the number of averted HIV infections among IDUs due to their injection behavior, is estimated as a function of the level of coverage of the program [26].
More than 15 years of research on HIV/AIDS prevention interventions with IDUs, crack cocaine users, and many of their sex partners has shown that community based outreach is effective for all types of drug-using risk groups, in a range of local settings. Cumulative research from a 23-site study that followed 18,144 drug users (13,164 IDUs and 4,980 non-injecting crack users) reports that 3 to 6 months after participating in the intervention, 72 percent of the IDUs either stopped injecting drugs or reduces their frequency of injection. Of those who continued to inject, nearly 60% either stopped or reduced reusing their syringes. 26% of the crack cocaine users, including 8,184 IDUs also used crack and 4,980 non-injecting crack users, had stopped using crack cocaine at follow-up. Nearly 25% of the 18,144 drug users who participated in the study had entered drug abuse treatment at the follow up, many for the first time [27]. This report proves that if D.C. funded needle exchange programs, which would ultimately allow workers to influence the drug users, that there would be a dramatic decrease in users and the AIDS rate.
[39]
Similarly to Ron Daniels effort to distribute sterile needles, my solution would further push the needle exchange program. Unless the ban of needle exchange in D.C. was eradicated, funding for this program could only come from private donors. It would require a lot of money to support the ideal program needed to help the drug users in Washington D.C. however, it would be very cost effective in the long run. I would expand Daniels effort and hire more staff, have more vans reaching the drug users at night, and have a building that the program will be based out of [28].
I would base my organization out of a homeless shelter located two blocks from the capitol. The Community for Creative Non-Violence (CCNV), located in N.W. Washington, is an outreach program for the homeless that I would transform to not only be an outreach program, but also an education and testing center for AIDS. It has a bed capacity of 1,350 and has been serving the homeless for over thirty years. The location of this shelter is ideal because it is in the center of the area with the highest AIDS rate [29].
I will have mobile units that will reach drug-using populations at a variety of locations and at a range of operating times. Not only will I pass out sterile needles, but I will also distribute condoms, pamphlets on how to reduce the risk of contracting the disease and where to go if you need help, and give the option of the Oraquick test. The Oraquick test is a twenty minute test that will allow the drug users to be tested immediately instead of having to be transported to a nearby clinic. I will target the drug users who already have HIV and their sex partners because research has demonstrated that HIV positive drug users are able to make major behavioral changes to protect their injecting and sex partners from contracting the infection [30].The cost analysis of my solution mainly depends on the salaries of my employees, the cost of condoms, syringes, and the oraquick test. If I wanted to have an organization with twenty employees with a salary of $ 30,000 working 5 days a week, and always having 10 people to there to work, would roughly be $600,000. A box of 100 3cc needle syringes costs $26.79. By passing out roughly 300 sterile needle syringes a night 5 nights a week, the estimated cost would be $20,896 a year. A box of 100 condoms now costs $29 dollars, roughly passing out 100 a night for 5 nights a week would roughly be $7,540. As well as performing 10 Oraquick AIDS tests ($15 each) a night would come to $39,000 a year. In order to put my solution into affect I would need funding for $667,436 not including my transportation costs [31].
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By launching this program the HIV rate would decrease as well as the amount of IDUs. To my advantage, NIDA has already set forth the foundation for a solution that would benefit Washington D.C. tremendously if put into action. However, Washington D.C. must act soon in order to reduce the number of contaminated syringes in circulation in the D.C. area and increase the availability of sterile injection equipment, thereby reducing the risk that new infections.