However, the federal government continues to ban the use of federal funds to support needle exchange programs. Despite the scientific findings documenting the effectiveness of needle exchange programs, and the evidence that unsafe injection practices continue to be the direct or indirect cause of one in three AIDS cases reported in the United States, the future of needle exchange in this country remains uncertain (Brodhead, 1999). .
Politics have been the determining force in public health interventions every since the Jeffersonian-Democratic and Federalist parties split over whether yellow fever was contagious or not during the "Great Philadelphia Outbreak" of 1793 (Moss, 2000). Even today politicizing is extremely prevalent during infectious disease outbreaks. Because legislators are not scientist they do not fully respect the quality, extent, or the validity of research. The power of the political process is very seductive, but letting the political process decide what can be talked about is in the long run, giving up or limiting the power of empirical research (Moss, 2000). Activists are usually the force behind public awareness, especially when a particular group or groups are affected or disproportionately represented. Beginning AIDS research and treatment funding in the United States was a moral crusade driven by gay activism and powered by the idea that stigmatization should not prevail (Moss, 2000). Nevertheless, some states refuse to accept needle exchange programs as a preventative intervention method, thus helping to promote an infinite epidemic.
It is incontrovertible that HIV is transmitted among intravenous drug users through the use of contaminated needles (Fernando, 1993). Restrictive access policies and criminalization of drug paraphernalia possession attribute to increases of HIV cases among intravenous drug users. The United States has the highest incidence of HIV among drug users and yet remains the only Western nation that has not liberalized its needle access policies.
