New Jersey has high rates of HIV and hepatitis infections among injection drug users. NJCRI's Project Access is a syringe exchange program in Newark that seeks to reduce harm from drug use by providing clean syringes. It has enrolled over 1,300 clients since opening in 2008 without any local, state, or federal funding. Studies show that syringe exchange programs reduce disease transmission and connect clients to treatment and social services without increasing drug use.

1. NJCRI’s Project AccessThe Newark Syringe Exchange Program Bob Baxter, Director N.JC.R.I.

2. New Jersey has the highest rate of HIV due to injection drug use (IDU). Approximately 40% of the 71,812 individuals identified as being infected with HIV are IDUs. Hepatitis and HIV remain prevalent in IDUs. Blinded studies in drug treatment programs indicate infection rates of 50% - 90% in injection heroin users. Why Exchange Syringes?

3. Harm Reduction seeks to minimize the harm caused by injection drug use. It is based on the principle “one new syringe for each injection.” It attempts to reach people “where they’re at.” Principles of Harm Reduction

4. Precontemplation (Not yet acknowledging that there is a problem behavior that needs to be changed) Contemplation (Acknowledging that there is a problem but not yet ready or sure of wanting to make a change) Preparation/Determination (Getting ready to change) Stages of Change

5. Action/Willpower (Changing behavior) Maintenance (Maintaining the behavior change) and Relapse (Returning to older behaviors and abandoning the new changes) Stages of Change (Cont…)

6. action Stable behaviour preparation Maintenance contemplation relapse Pre-contemplation Stages of change model

7. In 2007 New Jersey became the last state to liberalize access to syringes without a prescription. Syringe Exchange Programs (SEPs) are totally anonymous, no identifying information is collected. SEPs are pilot programs and only allowed in six cities. History of NJCRI’s Project Access

8. In 2007 the City of Newark applied to the state to open a Syringe Exchange Program. NJCRI secured private funding and received permission from the City of Newark to open NJCRI’s Project Access. Project Access opens on February 19, 2008. Initial goal was to enroll 175 clients. History of NJCRI’s Project Access (Cont…)

9. Present enrollement is approximately 1,300 clients. Funding has been secured from six foundations including: Comer Foundation Diamond Fund Health Care Foundation NJ AIDS Partnership M.A.C. AIDS Foundation Tides Foundation History of NJCRI’s Project Access (Cont…)

10. Presently budgeted at $120K per year. No local, state, or federal money is provided to NJCRI’s Project Access. Some funding was one-time only or start-up. Future foundation funding remains uncertain. History of NJCRI’s Project Access (Cont…)

11. Average client age is 40. Majority of clients are African/American. Sixty percent are male. Most clients are from Newark, Irvington, East Orange, etc. Results

12. Significant numbers of suburban youth are accessing the program. Approximately 30% of NJCRI’s Project Access clients request and are referred to drug treatment. Results (Cont…)

13. Restrictions on the use of Federal money to support Syringe Exchanges have been lifted. However, at present the Federal government is not funding SEP activities. State money maybe provided in the future. An evaluation report has been sent to the governor recomending funding and removal of the pilot designation for SEPs. Future of NJCRI’s Project Access

14. Reputable studies indicate that SEPs lessen the risk of infection with hepatitis and/or HIV. These same studies show no increase in injection drug use in localities with SEPs. SEPs serve as gateways to drug treatment, HIV counseling and testing, social services and medical services. Summary

15. SEPs are cost effective. Syringes cost approximately 0.08 cents each. Treating a single AIDS patient with hugely expensive drugs, and occasional hospitalization, now costs between $300,000 and $600,000 on average, according to the latest studies (Star-Ledger 11/12/09). Therefore, if Project Access prevents one case of HIV per year, it pays for itself many times over. Summary (Cont…)

16. Bob Baxter, Director NJCRI 393 Central Avenue Newark, NJ 07103 (973) 483-3444 x 132 b.baxter@njcri.org THANK YOU! Contact Information