HIV epidemic in Vancouver fuels debate over needle exchange. (Washington State)

Vancouver is in the middle of an HIV outbreak -- a finding that alarms public-health officials in the city with the busiest needle exchange program in North America. The numbers have renewed debate over whether needle exchange programs designed to prevent the spread of AIDS may actually encourage risky behavior.

The theory states that needle exchange programs introduce drug users to new social networks and new people to buy from and shoot up with. But observers say the correlation between HIV infection and participation in needle exchange -- shown in a bare handful of studies -- could simply mean that people who participate in needle exchange programs are at higher risk for getting the virus. The answer, they say, is not to eliminate needle exchange programs, but to supplement them with better treatment services.

A study in this month's issue of the journal AIDS found that one of the characteristics of about 1,000 HIV-positive injected-drug users in Vancouver was frequent attendance at a needle exchange …