PreventionWorks! Is Latest Casualty Of Home Rule Fight

We often talk about D.C. voting rights and self-determination in very academic terms, but not having either can have very real consequences. Today's closure of one local service provider proves that.

Today marks the end of PreventionWorks!, a small non-profit organization that over the last 12 years has operated one of the District's largest needle-exchange programs. For nine of those 12 years, PreventionWorks! struggled under a ban on the use of local funds for needle-exchange programs imposed by Congress in 1998.

That ban was lifted by Democrats in 2007, allowing PreventionWorks! to take in roughly $300,000 a year in city funds for its programs. It was too late, though -- years of working with nothing but private donations left the organization unable to establish firm financial footing. In a statement posted to its website, the organization's board of directors wrote: "Recent government support was critical to giving PreventionWorks! the potential for staying power, but unfortunately the organization was ultimately unable to build and sustain the financial and organizational capacity worthy of its work."

PreventionWorks! provided a service that is desperately needed in the District. According to a 2008 report by the D.C. Department of Health, Washington's HIV/AIDS rate stands at three percent of the city's population, above the level of some Western African countries. While the leading cause of transmission is men having sex with other men, 18 percent of all transmissions come from the reuse of needles. Research has shown that needle-exchange programs are effective in limiting HIV transmission and opening doors to other needed services; just last week, the U.S. Surgeon General issued a statement citing a study that found that "[needle-exchange programs] are widely considered to be an effective way of reducing HIV transmission among individuals who inject illicit drugs and there is ample evidence that [needle-exchange programs] also promote entry and retention into treatment."

Mary Beth Levin, the group's Director of Programs and Services, tells DCist that in 2006, during the congressional ban, PreventionWorks! served 1,963 people and exchanged 236,278 needles. But according to a 2007 profile in The New York Times, then-director Ron Daniels pointed out that the organization was only reaching one-third of the District's estimated 9,700 intravenous drug users. "For every person I help, there're seven more I can't reach. But I'd be reaching a lot more if my hands weren't tied," Daniels said.

Last year, PreventionWorks! served 2,267 people, exchanged 106,797 needles, provided 1,201 HIV tests, gave out 108,216 condoms and had 78 clients enter drug treatment. And though it was one of four organizations in the city providing needle-exchange services, it remained the largest -- over half of all needle-exchanges were handled by PreventionWorks!.

Levin told us that clients were "heartbroken" and "burst into tears" at the news of the organization's closing, which depended on 11 full-time staff, 150 volunteers and a beat-up beige RV. (The Post's Petula Dvorak followed the RV for a column published today.)

In a thoughtful interview with The Fightback's Pete Tucker last week, Ron Harris, a former employee of the organization, expressed doubt that the gap left by PreventionWorks! closing could be filled. "I don't believe, right now, we understand the ramifications of PreventionWorks! closing. I commend the other organizations who are going to try and pick up the slack, but there is such an unseen, voiceless…population out there that needs the service that PreventionWorks! provides. I don't know if the other organizations, right now, are up to speed to meet that need."

The three remaining needle-exchange organizations -- Family Medical and Counseling Services, Helping Individual Prostitutes Survive (HIPS) and Bread for the City -- will be forced to pick up the slack in the wake of PreventionWorks! shutting down. In a blog posting yesterday, Bread for the City asked for donations to help expand its needle-exchange capacities; according to the organization, it gave out 5,000 needles last year to 350 clients.

Even if PreventionWorks! wasn't closing, the future still remains murky for needle-exchange providers in the District. The new Republican House majority has already announced that it will seek to reimpose bans on local funding for both abortions and needle-exchange programs. The Senate may well prevent those from going into effect, but one things remains clear -- Republicans still love to pander to their most conservative wing by doing things to the District they can't do elsewhere.

Ultimately, we'll never know whether the District's rate of HIV/AIDS infections would have been any lower had Congress never made life so hard for PreventionWorks! and similar organizations. But what is clear is that the District's second-class status isn't just theoretical; it has very real implications for all D.C. residents. Most often, it's those that can't fight back that are hit hardest.

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http://dcist.com/2011/02/preventionworks_becomes_casualty_in .php

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