At your Board's request, in July 1999, the Health Services Agency convened a Hepatitis C Task Force, comprised of affected community members, County health experts and expert community health providers to determine the extent of the epidemic in the county and develop a plan of action. The task force completed its assignment and presented a plan to the Board in December, 1999. Funds were allocated by the Board to: study Hepatitis C virus (HCV) prevalence and distribution, increase awareness of HCV in high-risk populations, and make recommendations regarding further HCV efforts in San Mateo County. To determine the extent of the Hepatitis C endemic in San Mateo County, a point prevalence study, which concluded in September 2000, was conducted. The aim of the study was to estimate HCV seroprevalence in local high-risk individuals, to identify factors locally associated with HCV infection, and to gather initial information on drug use in identified populations. The study provided HCV testing to 1026 persons in population groups considered at high risk for HCV infection. HCV seropositivity was highest among participants recruited through needle exchange sites (N=272, 52.9% positive), followed by the jails (N=176, 30.1% positive), HIV clinics (N=77, 28.6% positive), and the ATS sites (N=501, 22.8% positive). The study was presented to the Board in March 2001. From that presentation, a Task Force was initiated to review and make recommendations on the current status of and the long-term plan for needle exchange in the county. The attached report is the result of the work of the Board-commissioned Needle Exchange Task Force. |
The task force began meeting in the Fall of 2001 and concluded its mission in 2002. The activities of the task force include: reviewing needle exchange programs locally and around the world, reviewing the known science about needle exchange programs, reviewing the current legal status of needle exchange in the county, and gauging public support for needle exchange activities. After reviewing these data, the task force adopted operating principles on which to make recommendations. These operating principles are to: · Minimize barriers to accessing clean needles and syringes · Maximize access to clean needles and syringes both by geographic location and time · Maximize collection of used needles · Use needle exchange as a conduit to support services and ultimately recovery. The currently operating needle exchange program, which has been in San Mateo County for over 10 years, will end this summer due to loss of funding. There are no other funding sources for this program. The task force recommends that needle exchange continue in this county and that it be integrated into existing programs to the degree possible. The total lifetime cost of single AIDS patient is $120,000 and the total lifetime cost of a Hepatitis C patient can run $250,000. An effective program will prevent dozens of infections with HIV/HCV per year. The total full cost of an effective needle exchange program in San Mateo County is about $390,000 per year. That program would include integration of needle exchange into existing programs, assigning additional work to staff already in place and contracting for some outside services. Health Services will continue to work with other county departments and with outside sources to develop funding proposals for submission to your Board. |
The Needle Exchange Task Force report keeps the commitment of Ensuring Basic Health and Safety for All and goal number 8: Help vulnerable people-the aged, disabled, mentally ill, at-risk youth and others-achieve a better quality of life. Needle exchange supports disease reduction and is a vehicle for users to get to support services and ultimately to recovery. |
