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X. CONCLUSION

In vetoing legislation that would have authorized the nonprescription pharmacy sale of sterile syringes, California Governor Gray Davis stated that he was “committed to the underlying goal of the bill which is to reduce the transmission of HIV and hepatitis C among injection drug users, and . . . proud of the progress we have made in combating these two diseases.”²⁴⁶ Davis made special mention of AB 136, which, he said, brought together law enforcement and public health officials to decriminalize supervised syringe exchange programs. He also noted the financial commitment his government had made to HIV and hepatitis C prevention and treatment.

It is difficult to reconcile these pronouncements with California’s continued hostility to syringe access interventions. For many injectors in California, syringe regulations still present an unacceptable choice between breaking the law and engaging in high-risk, potentially fatal behavior. “I’d rather go to jail than get AIDS,” said Elnora D., asked why she assumes the risk of taking syringes to and from syringe exchange programs.²⁴⁷ Others, like Cody F., will make the more fatal choice: “I’m more afraid of carrying syringes than sharing them,” he says.²⁴⁸ As long as the authorities systematically undermine syringe exchange programs and oppose further syringe access measures, California’s financial investment in HIV and hepatitis C prevention will be jeopardized.

Syringe access law in California is characterized by contradiction and political compromise, not by reason and respect for human rights. Local jurisdictions are forbidden from authorizing syringe exchange, a proven form of HIV prevention, until the disease has already reached emergency proportions. Agents of the state are permitted to distribute syringes in certain jurisdictions, but the individuals to whom they distribute the syringes are forbidden from possessing them. Outreach workers all over California freely provide information on safe injection, but only in selected jurisdictions may they give drug users the tools to put that information to use. Drug users are ordered to return used syringes for safe disposal, but they can be arrested for possession of drug paraphernalia on their way to the biohazard disposal container.

Such hypocrisy not only offends common sense; it may prove fatal to people who inject drugs, their sex partners, their children, and others whose HIV infection is linked to injection drug use. It has been estimated that thousands of HIV infections, and indeed millions of dollars in health care costs, could have been avoided in the United States had the federal government implemented syringe exchange nationally in the 1980s. California, with its patchwork of legal, illegal, and quasi-legal syringe exchanges and its contradictory laws and policies, is a microcosm of this national picture. Its leadership on this issue of critical importance, guided by a respect for the human rights of those most at risk of HIV infection, could reaffirm that life is more precious than ideology.