The Letter Miss America, Kate Shindle, wrote to President Clinton
pleading for support of Needle Exchange Programs

April 6, 1998

The Honorable William J. Clinton
The White House
1600 Pennsylvania Avenue, NW
Washington D.C. 20500

Dear President Clinton:

I am aware that your administration is once again reviewing the issue of federal funding for needle exchange programs, which affects the lives and futures of thousands of American men, women, and children each year. Once again, organizations across the country have been discouraged and frustrated at the outcome of one of these reviews. I am asking you to use federal funds to support needle exchange programs and prevent the spread of the HIV/AIDS epidemic.

It has been eighteen years since AIDS began to decimate American families, and the epidemic shows no sign of slowing. Despite recent breakthroughs in AIDS treatment, the number of new infections continues to explode. Every day, 16,000 people, somewhere, contract HIV. And as you know, the epidemic is undergoing a dramatic demographic shift. Women, minorities, and the young are being infected at unprecedented rates. Every hour of every day, two American teenagers contract HIV. And heterosexual women account for the fastest-rising group of new infections. AIDS is no longer restricted to any one social group. It's happening to all of us.

But a unique phenomenon continues to sweep our nation. It is the dynamic created by a desire to end the AIDS epidemic and a hesitance to implement the programs which will eradicate it. We know exactly how to stop the spread of HIV. In the absence of a cure, scientists, educators, and public health officials agree upon the need for strong and proactive programs which empower individuals to protect themselves from this virus.

Statistics regarding the prevalence of HIV infection among IV drug users are astounding. 63% of all AIDS cases among women are related to the sharing of needles - these women contract HIV either through IV drug use or through sex with an IV drug user. Similarly, 58% of pediatric AIDS cases are attributable to a parent's drug use. Clearly, drugs are killing Americans in more ways than one.

But needle-exchange programs are overwhelmingly effective in combating HW infection. By providing clean syringes in exchange for used ones, we can easily prevent the sharing of contaminated drug paraphernalia. Needle exchange programs prevent HlV from being spread. In Baltimore, the HIV seropositivity rate was reduced by 40% during the program's three-year trial period. And the community benefits as well. The lifetime cost of treating just one person with AIDS is estimated to be $119,000, while the median cost of running an exchange is just $169,000 - eliminating a significant financial burden on taxpayers. And by providing the opportunity for a one-to-one syringe exchange, we can all but ensure that there are no contaminated needles lying around in streets, on playgrounds, or in other places where children can find them and hurt themselves.

President Clinton, we are all familiar with the so-called arguments against needle exchange. Quite frankly, the idea that these programs promote drug abuse is unreasonable, and outdated, and has already been categorically disproven. Seven different independent agencies, including the Centers for Disease Control and the University of California at San Francisco, have shown unquestionably that there is no increase in the incidence of drug use in communities where needle-exchange programs have taken hold. In fact, the rate of use can actually decline when staff are able to counsel drug users into treatment. No one wants more drugs on our streets.

It's time to take action. Every 5.4 seconds, someone contracts HIV. While we bide our time and weigh our options, people are still dying. There seems to be a lot of "morality" talk surrounding HIV/AIDS prevention. Ironically, we have forgotten our moral obligation to save lives. We need to provide the information and tools which will empower all Americans to protect themselves. I am twenty-one years old, and my generation is dying.

It's time for us, finally, to have an intelligent and substantive dialogue about needle exchange. No more stalling. No more "looking into the issue." We no longer have the luxury of time. The facts are on the table. The AIDS-services community has done what you asked by providing these findings. Approximately 60% of Americans approve of needle exchange, and are watching. Mainstream America cares about this. Now you need to hold up your end of the deal.

There is still a lot of fear when it comes to talking about this issue, and dozens of warring factions. No one ever said ending a global pandemic would be easy. America needs money for needle exchange. We need to let scientists and public health officials determine the need for such programs on a community-by-community basis, and then we need funding to support their efforts. At this point, there is no more room for excuses. Americans are still dying, and we are to blame unless we protect them.

Sincerely,
Kate Shindle
Miss America 1998