Needle-sharing and HIV/AIDS
NEW DELHI, India (JP): The dangerous practice of needle- sharing among Intravenous Drug Users (IDUs), which has intensified the spread of the HIV/AIDS epidemic in many countries, has been a major concern among non-governmental organizations (NGOs) all over the world.
Many NGOs in Third World countries have been trying to eradicate this risky practice as much as their limited manpower and funds allow.
Some have won support both from their government and community to implement full-scale Needle and Syringe Exchange Programs (NSEPs), while there are also NGOs that succeed in dispensing substitute drugs which can be taken orally.
Meanwhile, NGOs in countries culturally and religiously opposed to those remedies opt for low-profile solutions, such as raising the IDUs' awareness of the grave dangers of the practice through leaflet distribution and other educational efforts.
The good news is that several companies specializing in manufacturing medical and medical-related products have also paid a lot of attention to this issue. The results have been the emergence of several products specifically designed to reduce the use of contaminated syringes and needles.
One of those products is the Vanishpoint syringe, which was exhibited during the 12th International Conference on the Reduction of Drug Related Harm, held here last April.
Manufactured by Texas-based Retractable Technologies Inc., the needle on a Vanishpoint syringe is automatically retracted after injection, rendering both the syringe and needle virtually useless after just one injection.
Automatic retraction is activated by fully depressing the plunger while the needle remains in the recipient's vein. The company has also manufactured a blood collection tube with the same mechanism.
"Vanishpoint syringes require: less disposal space than a standard syringe, preventing disposal-related injuries; minimal training; and can be activated by just one hand," the company's Executive Vice President Lillian E Salerno said.
In a country, in this case the US, where 40 percent of new HIV infections are directly or indirectly caused by contaminated needles, and where needlestick injuries result in 50 to 60 HIV infections each year, the Vanishpoint syringe seems to be the solution that, for years, everybody has been waiting for.
"We received a very warm response both from the medical community and the general public. Last year we sold around 30 million syringes, a soaring 20 million units more than we sold in 1999. We have estimated that in 2001 we will sell around 70 million units of this syringe," Salerno said.
The street price for this syringe in the U.S. is around 40 U.S. cents, definitely more expensive than a standard syringe, which only costs around 6 cents. Unfortunately, the price would probably be doubled, even tripled, in Third World countries, especially the ones that have been crippled by the Asian economic crisis, such as Indonesia. This is a major obstacle to popularizing the syringe among IDUs.
"We are in the process of looking for local manufacturers in Asia. If we can find them we will be able to reduce several costs and eventually lower the price of the product," Salerno said.
Vanishpoint's design has one flaw though, as pointed out by a drug user attending the conference. The Vanishpoint syringe and needle can be re-used if, in the first injection, the drug user does not fully depress the plunger, thus preventing needle retraction.
"Let's say, hypothetically of course, we use a 3 cc Vanishpoint syringe. After injecting one cc, and the needle hasn't been retracted yet, I pass the syringe to another user so he can inject another one cc. Then he can pass the syringe to a third user who will inject the last one cc of the drug. So, only after 3 cc of drug, and, unfortunately, 3 users, the plunger is finally fully-depressed and the needle retracted," he said.
Another expert at the conference also pointed out the need to conduct a thorough and extensive report before this new type of syringe could be judged fairly as an effective new tool in fighting the widespread HIV/AIDS epidemic.
Another medical product at the exhibition was the Sharpsafe Exchange plastic container for used syringe and needle disposal. The container features unsurpassed leakage resistance, a reinforced base for puncture resistance and a non-return feature ensuring that, once inserted, syringes and needles cannot be retrieved. Manufactured by Australian-based company Frontier the street-price of Sharpsafe Exchange is around $1. Some 50,000 containers are sold each month in Australia alone.
Ultimately, the awareness and commitment of IDUs in protecting themselves from HIV/AIDS is still a crucial factor in this battle. The best technology and appliances will prove useless if IDUs ignore them. (zen)