Needle exchange on trial.

Oakland

A tall, soft-spoken local official stood on the street, handing out syringes, alcohol wipes, and condoms to intravenous drug users in economically devastated West Oakland on a recent Saturday morning. Photographers and camera operators outnumbered needle-exchange clients, but Oakland city council member Nate Miley and four of his colleagues were making a point.

"The law is unjust and immoral," says Miley, referring to state statutes prohibiting the distribution of hypodermic needles without a prescription. The laws predate the HIV epidemic.

The real crime, according to needle-exchange advocates, is that activists continue to be arrested for trying to stem the spread of AIDS in a city with one of the highest intravenous-drug-related HIV rates in the country. In fact, Alameda County currently leads the nation in the number of pending needle-exchange prosecutions. Five activists with a group called the Alameda County Exchange (ACE) go to trial on February 27. If convicted, they face six months in jail and a $1,000 fine.

Since ACE was founded two years ago, the organization has handed out some 270,000 syringes and about 150,000 condoms. ACE currently operates weekly exchanges at three sites that are constantly moving to avoid police.

For their part, Oakland police say they are reluctant enforcers of the law. "We just want the law to be changed to make it legal. That's the bottom line," says Sergeant Ron Jones, speaking on behalf of Police Chief Joseph Samuels. But California Governor Pete Wilson has vetoed needle-exchange bills three years in a row.

"They feel drug addicts need to be punished, that they are worthless," says AIDS activist Barbara Garcia.

The Clinton Administration has been sitting on a Centers for Disease Control review of the most comprehensive study of needle-exchange programs done to date by researchers at the University of California medical school in San Francisco. Sources close to the study say the CDC endorses needle exchange and would bolster efforts to lift the ban on federal funding for such programs. Lawyers for the five Oakland activists plan to subpoena the CDC review as evidence that needle exchange does not promote drug use and stops the spread of AIDS.

"The federal government knows that needle exchange is of critical importance, and for political reasons is hiding it," says Bill Simpich, one of the attorneys representing the five ACE activists.

In West Oakland, 20 percent of the injection drug users are HIV positive. African-Americans are disproportionately affected.

"I am African-American. I live in Oakland. I feel morally compelled to do needle exchange," says defendant Ricky Bluthenthal, a UCSF researcher who spends his work week interviewing IV drug users. The Alameda County District Attorney's active prosecution of needle-exchange has put him at odds not only with ACE but with the Oakland City Council, the Alameda County Board of Supervisors, and the mayor, who all endorse needle exchange.

Needle exchange won early support in San Francisco because of organized AIDS activism in the city's gay community. Politicians could not afford to oppose a program designed to stop the spread of AIDS among addicts. A few miles away, drug users in the East Bay have no organized community to advocate for them, beyond the handful of activists willing to risk arrest each week.

Council member Nate Miley says that the outcome of the ACE activists' trial will likely affect how tenaciously the D.A. continues to prosecute needle-exchange activists. Meanwhile, Miley and other members of the city council will continue to volunteer occasionally with needle exchange in the hope that by breaking the law they can help change it.