American Notes HAWAII

The Honolulu neighborhood is seedy, the building rundown and the second-story room bleak. When a drug user comes in, drops a dirty needle into a plastic bucket and receives a fresh sterile syringe and needle in exchange, no name is given, no questions are asked. This is the start of the nation's first state- approved program for providing addicts with clean needles in the hope of curtailing the spread of AIDS. Under the two-year pilot project, an addict can swap a used needle for a new one, supplied by the nonprofit Life Foundation, up to five times a day, five days a week.

The program was passed by the state legislature over the objection of opponents who argued that it would only encourage drug abuse. But proponents pointed out that 18% of the 77 new AIDS cases that surfaced in the last half of 1989 were directly or indirectly caused by IV drug use, and as a result the number of infants born HIV positive during that period has jumped sharply. Says Dr. Jeffrey Schouten, president of the Life Foundation: "If we can even prevent one child from being born infected, it's worth it." During the first week, 62 soiled needles were traded for fresh ones.