HIPS supplies syringe tops for various parts of the body.
Demand Skyrockets After PreventionWorks! Closes
But the group, Helping Individual Prostitutes Survive, or HIPS, is also struggling to keep up with demand. Since the District's main needle exchange program, PreventionWorks!, closed in February, HIPS has been overloaded with requests.
Jenna Mellor, who coordinates the needle exchange at HIPS, says it hasn't been the same since PreventionWorks! shut its doors.
We've been getting a lot of calls of someone saying, 'I've been re-using my needles for a month! I need new needles! I want new needles! How do I meet up with you,'" she says.
The answer? They can come to the HIPS facility in Northeast D.C., or meet up with the van Mellor drives around town each night. HIPS exchanges used needles for clean ones to help prevention infection.
As the nonprofit's name suggests, many of HIPS' clients are, indeed, sex workers. But Mellor counters that needle exchange participants hail from all walks of life.
Exchange benefits all walks of life
"Young people, old people, black people, white people, trans people, people who work for the government, people who have no home," she says.
They use needles for all sorts of reasons. As might be expected, many people use them to inject heroin, cocaine, or crystal meth; the Centers for Disease Control estimate injection drug use has led to more than a third of the nation's AIDS cases, and D.C. is the HIV/AIDS capital, with 3 percent of all residents infected.
But also there's a whole range of reasons people would want new needles. People who are having trouble with health insurance but have diabetes, people who are injecting steroids, people who are using club drugs, and people who are using hormones.
One of the latter is Teola, a transgendered person from D.C.
Sitting in one of the private needle exchange rooms at HIPS, she's wearing false eyelashes and a tube top, and her metal hoop earrings jingle as they brush her shoulders.
Drug use not the only reason for exchange
"I take muscular injections for hormone therapy," Teola says. "I've been doing this for like the last four years."
Teola takes hormones to modify her body; other transgender people might inject silicone, too.
"In the beginning, when my doctor would prescribe me the prescription, I would have problems getting the syringes, or I wouldn’t have the money for the syringes, you know, by me being on a limited income," she says. "Then the needle exchange came through and I didn't have to worry about that anymore."
The problem, she says, is many of her friends don't bother with needle exchange, often because they're buying "hot" hormones off the street.
"They won't go to the doctor because they don't have the right insurance and all that," Teola explains. "But they'll buy it off somebody, so they might give them one needle. But there might be two girls paying for the hormones together. And they will share needles like that.
"Because, see, people think that if you're not using intravenous drugs, needles are not dangerous," she adds.
In addition to swaps, helping people make changes
HIPS doesn't just hand out sterile needles: it gives advice on proper usage, it cautions about the risks of sharing, and it tries to help intravenous drug users, quit.
Because one of the criticisms exchange programs hear all the time is that needle exchange provides incentives for drug use. But Ed Gadson, a "client advocate" at HIPS, disagrees.
"As we talk with them, and they express 'well, I want to do this for now, but I want to stop,'" he says. "And we try to get them their ultimate goal, and a lot of their ultimate goals is 'I want to stop.' But in the meantime, they say, 'I will do this, to make it safer for me.'
Each month, HIPS refers about three needle exchange clients to treatment; that's out of 80 to 90 clients. But Gadson feels there's hope for intravenous drug users, because he used to be one.
"I became HIV-infected through intravenous drug use. I've been infected 24 years," he sasy. "I stopped using 17 years ago."
His health is still strong, but that hasn't stopped him from wishing he had more options from back then.
"I'm doing great. But, actually, I really wish they would have had a needle exchange back 24 years ago," he says. "I don't think our numbers would have been quite as high.
He's probably right, says Mellor.
"The D.C. Health Department says it only takes 5 percent of the needles people use to be new to reduce the HIV infection rate in the city," she says.
Like Gadson, Mellor is aware of the skepticism surrounding needle exchange. But in the end, she says, it's a matter of public health but also human dignity.
"I think it's such a powerful thing to give someone access to what they want to keep themselves safer," she says. "No one should have to live with HIV or hepatitis-C because we don't think people deserve access to very cheap, very usable resources."