From Underground to Above-Board, Syringe Exchange Program Has Helped Reduce HIV Transmission For 15 Years

By Andy Smith

It’s only Jose Benitez’s third week on the job as Executive Director of Prevention Point Philadelphia, but he seems fairly comfortable in his new position. Not surprising, really. Though Benitez is new to PPP, he’s been “doing HIV work in the Philadelphia community since 1989.”

And his first major assignment is a big one: overseeing this multi-faceted AIDS service organization’s 15th Annual Gala.

Benitez, his staff, volunteers, board and donors are honoring Pennsylvania’s second-term Governor Ed Rendell, the man who, as mayor of Philadelphia in 1991, issued an injunction decriminalizing syringe exchange as an HIV prevention method among his city’s population.

“Ed Rendell was one of the first elected officials in the nation to take action to prevent injection-related HIV.  When most officials wouldn’t even talk about the issue, Rendell had the courage and compassion to do the right thing and put saving lives above playing politics,” says Benitez.

Rendell’s courageous injunction allowed Prevention Point to transition from an underground organization supplying clean needles to people on the streets to a multi-services provider offering healthcare, counseling, legal advocacy services – and, yes, free syringes – to Philadelphia’s underserved populations.

Even now, though, the organization must be very careful about the money it spends to provide free needles, bleach and the other disinfecting resources it distributes to people at risk of contracting HIV.

“For our November 15 gala cocktail reception, we’re asking for a $50 donation to be used for the syringe program,” says Benitez, who explains that only specifically designated funds like these can be channeled into the ASO’s needle exchange efforts. “We have to be very careful with funding for our syringe exchange program, because none of our federal funding, our Ryan White money, can go to syringe exchange.”

And when federal funding isn’t an option, grants – even small grants, like the $5,000 BC/EFA has given PPP annually for the past several years – can make a big difference.

Workin’ the Streets
“Every week, our Syringe Exchange Program (SEP) provides access to sterile syringes at six sites across Philadelphia.  Beyond syringes, we also provide access to HIV counseling, testing, and referral; harm reduction counseling and education; referrals to drug treatment; advocacy; and social services,” says Nicole Leighton, who heads up the syringe exchange program.

“I’d say we serve about 7,000 unduplicated clients a year and through the years we’ve seen about 15,000 different clients,” she says. “Some have stopped using; some have died and others have just moved away.”

Does the sometimes controversial practice of providing free syringes to drug addicts work?

“There’s a huge canon around syringe exchange. Nationally and internationally, it has been proven effective,” says Leighton. She cites a study conducted by the Treatment Research Center of the University of Pennsylvania, which showed that “our efforts reduced the rate of HIV infection among injection drug users from 7% to 3%. If any other form of intervention were this effective, it would be part of public health policy everywhere.”

A Spectrum of Survival Services
There’s little doubt that Prevention Point’s efforts target some of Philly’s neediest people, clients both overwhelmingly poor and isolated from the mainstream economy:

  • 67% have neither full-time nor part-time work,
  • 38% rely on welfare or other benefits,
  • 16% rely on commercial sex work for survival, and
  • over 70% face extreme poverty

Through its 15-year history, PPP has expanded its base of services to help these struggling communities through four other essential programs:

The Prevention Services Program (PSP) is a comprehensive HIV prevention program providing HIV counseling, testing and referral, and harm reduction counseling services to over 1,000 clients annually.

The Street-side Health Project (SHP) provides free medical care and family planning/STD services to over 600 clients annually using a mobile unit for outreach as well as a clinic at the Harm Reduction Drop-In Center. Teams of volunteer medical, nursing, and pharmacy students and professionals provide acute medical services including STD screening and treatment, pregnancy testing, vaccinations for hepatitis and influenza, basic physical exams, wound and abscess care, treatment for infections, and drug interaction counseling.

The Legal Advocacy Program (LAP) provides services to approximately 70 clients annually. A staff attorney and volunteer law students provide legal referrals, take reports of police harassment, and provide assistance in resolving criminal and civil legal matters.  LAP also provides training to the Philadelphia Department of Police on blood-borne pathogen exposure and the benefits of syringe exchange to officer safety and public health.

The Trans-health Information Project (TIP), a collaboration between PPP and the Gay and Lesbian Latino AIDS Education Initiative (GALAEI), is a peer-based health-care access and education program for transgender people.  TIP serves over 170 transgender people annually through outreach and education, providing Prevention Case Management and Group Health Education.

Helping Themselves Help Others
To continue providing all of these services in a shaky funding environment, Benitez knows he must continue PPP’s efforts to diversity its funding sources, rather than relying completely on government contracts, as it has for most of its history.

“When you work on contracts, you are always at risk,” he says. “There is no operational reserve and, more importantly, there is no money available to hire development staff to raise money to pursue future strategic opportunities.”

“Working with PPP’s board, my goal is to aggressively pursue foundations and individuals to support our work and build on our funding base,” he says.

To learn more aobut the work of Prevention Point Philadelphia, visit the organization’s website at