Dr. Ronald Collman, Director of the Penn Center for AIDS Research at the University of Pennsylvania, and Dr. Florence Momplaisir, Assistant Professor in the Division of Infectious Diseases and the Vice Chief for Diversity, Equity, and Inclusion, the Perelman School of Medicine at UPenn, discussed Philadelphia’s rank as a national top 50 ‘hot spot’ by the CDC for new HIV transmissions and their concerns for the city if Syringe Exchange Services are stopped.  

After discussing the biology of HIV we looked at the numbers for our city, 
20,000 persons with HIV in Philadelphia, 30,000 in region with almost 400 new infections per year.  While two-thirds of the people living with HIV are on treatment and suppressed, a third are not and are able to transmit the virus.  In Philadelphia 28% of the persons with HIV are women, one of the highest percentages in the country.  The primary transmission method is sex, however intravenous drug use is another cause, one that can soon explode with new city restrictions on needle exchange programming.  
Treatments for HIV are great, but not as great as staying HIV negative: even with therapy, people with HIV are more likely to get the conditions of ageing including heart attacks, cancers, dementia and kidney failure.   Prevention is vital, if treated a person can reach U=U status, undetectable means un-transmittable.  PrEP, either daily oral or by scheduled injection, prevents infection, and there is even a ‘morning after’ medication that can prevent the disease even through contaminated needle transmission. 

Breaking down the numbers 64% of PWH are Black and 16% Hispanic.  The rates are 7x higher in Black & Hispanic and a Black male having sex with males faces a 1:3 lifetime risk for infection.  We discussed the underuse of treatment and PrEP in ethnic and minority communities, a combination of lack of knowledge and lack of access.  Youth numbers are also increasing, through carelessness and a mistaken belief that it is not a concern any more or that their circles are not affected.

The two made their case for continued Syringe Exchange Services noting that when introduced to Philadelphia in the 90’s, it reduced HIV transmission by 95%.  They pointed out that epidemics don’t stay contained, and will penetrate the broader Philadelphia community, in particular women who will have acquired it through sexual contact. 
  
They note that defunding clean syringes won’t stop people from injecting, and syringe exchange is a major way that IDUs end up linked to rehab care successfully.   

They also argued that saving $700,000 spent on needles will be more than offset by the cost for HIV and Hepatitis C care, as well as the cost of wound infections which is a huge burden on the City’s health care system and a big user of ER services, which makes it harder for others to access ER services.  

For more information about PrEp and other HIV services, contact the Philadelphia Department of Health at PhillyKeepOnLoving.com