There is a duty to counsel and assist them in obtaining drug treatment and to refer them to appropriate agencies for care. This population is often resistant to seeking treatment and there may be a scarcity of accessible, affordable and appropriate treatment beds. Shifting modes of transmission with intravenous drug users makes needle exchange programs important for the protection of the users and their sexual partners from fatal infections. Significant needle and syringe exchange programs exist in Europe and Australia and studies have shown a reduction in the rate of HIV infection in intravenous drug users. In contrast, many of the programs in the U.S. have limited funding and few sites, diminishing the impact of the programs.
States have the ability to legalize access to and possession of syringes.
This can be done by prescription or by deregulating sales by removing prescription requirements and relevant portions of paraphernalia possession laws. All disease reporting requires a system for maintaining confidentiality. Years of observing the successful application of public health interventions in dealing with other communicable diseases without any compromises to confidentiality support the argument for mandatory reporting. Improved treatments for HIV infected individuals, particularly pregnant women, which can both decrease the possibility of transmission and improve the length and quality of life for these individuals, also lend urgency to early identification of the disease. As the science continues to change and as the needs of HIV infected persons change, policies will also need to change.