Pediatricians should speak out in support of needle exchange programs to reduce the spread of HIV among injection drug users, the American Academy of Pediatrics says in a toughened policy statement.
Doctors also should discuss HIV risk with their teenage patients “with a nonjudgmental approach” and offer confidential help if local laws allow, the group says in the statement appearing Monday in the journal Pediatrics.
“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 the lead author, Dr. Lisa Henry-Reid of Chicago’s John H. Stroger Jr. Hospital.
The previous version of the group’s policy, dated 1994, said clean needle programs should be “encouraged and expanded.”
Half of new HIV infections in the United States are among people younger than 25, Henry-Reid said.
Unprotected sex is the most common way young people become infected, but sharing dirty needles or having sex with an injection drug user accounts for about 13 percent of youth AIDS cases.
The policy drew criticism from Wendy Wright of Concerned Women for America, the group that last year blasted the pediatricians’ academy for its support of over-the-counter emergency contraception.
“The recommendation will not rescue patients and neither does it promote healthy behavior,” Wright said. “Instead, they have been promoting programs that encourage riskier activities.”
The new policy statement says of needle exchange programs, which let addicts trade dirty syringes for clean ones: “Pediatricians should advocate for unencumbered access to sterile syringes and improved knowledge about decontamination of injection equipment.”
The beefed-up wording is based on research showing the programs reduce HIV infection, said Dr. Peter Havens of the Medical College of Wisconsin, a member of the committee that wrote the policy. Needle exchange programs can include counseling to further reduce risky behavior, but opponents say they work against efforts to fight drug abuse.
Congress has banned federal funding of needle exchange programs, but the Centers for Disease Control and Prevention says they can reduce the spread of disease without increasing drug use.
Thirty-six states and the District of Columbia have needle exchange programs, according to the nonprofit North American Syringe Exchange Network.