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Shot of the Day: An ACT UP Needle Exchange Protest


On World AIDS Day, a moment when New York City was the front line.

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The harm reduction movement has its roots in illegal needle exchanges, a form of activism that reached critical mass during the AIDS crisis in New York City—where, by 1991, 50% of heroin users were infected with HIV. Members of ACT UP organized public syringe swaps to get clean works into the hands of drug users. They also aimed to mobilize public support for overturning the law against needle possession, which not only made it illegal to exchange a dirty one for a clean one but also helped insure that using drugs remained in the shadows.

In this photo of a 1990 ACT UP demonstration—taken by none other than Allan Clear, the longtime head of the Harm Reduction Coalition—activists face off with a New York City Police chief as they attempt to enter City Hall to present the mayor, who opposed syringe swaps, with hundreds of used needles. Merely by carrying these used works, the activists were also challenging the police to arrest them—and therefore challenging the law itself.

In 1990, the “Needle Eight” (including Richard Elovich, in the center of the photo; the woman on the right is Gay Wachman) decided to get arrested for breaking that law and take the case to trial, facing a six-month sentence. But the New York City judge found them not guilty, ruling that “the harm the defendants sought to avoid was greater than the harm in violating the statute. Hundreds of thousands of lives are at stake in the AIDS epidemic”—the extraordinarily rare application of the “medical necessity” ruling.

Twenty five years later, on  World AIDS Day, the harm reduction movement is a powerful force. Yet despite the efforts of some 185 syringe exchanges in 36 states, the US infection rate among IV drug users hovers around 9%. The global stats are worse: 13%, or some 3 million, of all IV drug users have HIV, and only 4% have access to lifesaving treatment. In countries like Estonia, Russia, Indonesia and Pakistan, more than 25% of IV drug users have HIV, few sources of free clean needles exist and activists face harsh reprisals.