According to the Philadelphia AIDS Statistical Update, 33% of all “living with AIDS” cases in Philadelphia are the result of intravenous drug use, or IDU.[i] Map 12 displays the frequency of people living with AIDS due to drug use according to zip code. Eight zip codes, highlighted in blue, have more than 301 IDU “living with AIDS” cases.[ii] To address this increasing issue, a needle exchange program called Prevention Point Philadelphia (PPP) has been established. In an article analyzing the cost-effectiveness of Philadelphia’s program, Harris states that “PPP not only provides sterile syringes and clean injection supplies through its NEP [Needle Exchange Program], but also gives IDUs access to anonymous HIV testing and counseling, as well as referrals for drug treatment, medical care…and social and legal services.”[iii] The comprehensive approach to HIV prevention is an effective use of the city’s time and money because it is able to address the needs of a target demographic in a thorough and personal way.   http://citybelt.typepad.com/photos/uncategorized/needlesneg.jpg

            Yet, by making small changes in this existing program, the needle exchange in Philadelphia could be even more successful. Although PPP has locations in areas of high density IDUs, a map of these locations reveals that at least three of the zip codes with IDU cases above 301 do not have a PPP clinic. Harris recommends that “PPP needs to add 2 or 3 new sites in neighborhoods with the highest density of IDU AIDS cases.”[iv] He suggests zip codes 19132, 19121, and 19140: all areas with extremely high density of IDU users. In addition to increasing the number of locations, it is also necessary to extend the hours at these sights. A study done by Rose et al. showed that a late night “buffet” of needle exchange materials and HIV prevention information effectively reached a drug abusing MSM population in San Fransico.[v] The operating theory behind this study was that drug users were not being effectively targeted because they were on the streets at very late hours, hours when health care sights were not accessible. In fact, each site of PPP is open only one day a week, and none are open later than 5 p.m. Harris suggests that “PP also needs to increase its hours of operation at two existing sites, where the number of needles distributed per client is sub-optimal.”[vi] Indeed, it would be efficient and cost-effective if even two of the PPP sites offered late night hours to those IDUs that do not frequent the streets during the day. Harris suggests that a 28% increase in spending for this program, an additional $10, 388 per year, could greatly enhance the prevention goals of PPP in a cost-effective manner.