Ongoing need for Hawaii Syringe Exchange Program

Hawaii’s syringe exchange program (SEP), the nation’s first, was established more than 30 years ago by the Hawai‘i Department of Health to respond to the growing AIDS/HIV crisis in the state. It continues to demonstrate its effectiveness in preventing disease, based on the findings of the Hawai‘i Syringe Exchange Program 2019 Annual Report. The report was presented earlier this month to the state’s Syringe Exchange Oversight Committee.

The report highlights the following successes of Hawaii’s SEP:

• Exchanged more than 1.18 million syringes in 2019, effectively keeping used syringes out of parks and other public settings to minimize the chance of accidental needle-sticks;
• Maintained low HIV rates, far below those of other states, among persons who inject drugs and their partners over the past three decades;
• Conducted outreach using trained workers to support persons who are disproportionately unsheltered, unemployed, and have difficulty accessing medical care, one-quarter of whom identify as Native Hawaiian
• Provided overdose prevention training and nasal naloxone to over 1,000 SEP clients, law enforcement, and others who may encounter persons who inject drugs, since 2016;
• Referred clients for medical and social services, including HIV and hepatitis C screening, medical care for those who test reactive, and substance use treatment and other behavioral health services; and
• Provided experience-informed leadership and community insights for other health department initiatives, including the Hawai‘i Opioid Initiative and Hep Free 2030, the statewide hepatitis elimination strategy.

“Decades ago, HIV/AIDS was a new epidemic that was ravaging communities. Through public policy, funding and proactive intervention efforts with at risk populations , there has been much progress to combat the spread of the virus,” said Peter Whiticar, chief of the Hawai‘i Department of Health’s Harm Reduction Services Branch. “The initially controversial program has been proven to be effective. We cannot lose sight of lessons learned through the syringe exchange program’s successes in serving populations with limited access to health care who can be hard to reach. This is especially critical now as we work to minimize the impact and severity of COVID-19 in all communities.”

“This most recent annual report presents solid data that again demonstrates the syringe exchange program’s continuing innovation and effectiveness in preventing HIV,” said Heather Lusk, executive director of the Hawai‘i Health & Harm Reduction Center (HHHRC), which currently manages the state’s SEP. “As we struggle with the COVID-19 pandemic, the state is continuing to prioritize programs that address other preventable and treatable diseases like HIV/AIDS and viral hepatitis.

Background

The initial pilot program that began in 1989 prompted the Hawai‘i State Legislature and then Gov. John Waihee to pass a law in 1990 to establish the state’s first syringe exchange program, which was managed by the Life Foundation, the first and largest AIDS organization in the Pacific.

After demonstrating the safety and efficacy of the program, the Hawai‘i State legislature passed another law that enabled the Hawai‘i Department of Health to expand the program and implement a statewide syringe exchange to prevent the transmission of HIV, hepatitis B, hepatitis C, and other blood-borne pathogens, and to refer persons who inject drugs to health and social support services.

The law also required the health department to establish an oversight committee to monitor the progress and effectiveness of SEP, now managed by the Hawai‘i Health & Harm Reduction Center (HHHRC). 

To learn more about Hawaii’s syringe exchange program and to access the 2019 report, go to: https://www.hhhrc.org/sep