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III. METHODS

This report is based on a two-week field visit to California in January and February 2003 as well as prior and subsequent research. Human Rights Watch visited seven counties in California, each with a distinct approach to the regulation of syringes: San Francisco, Alameda, Sacramento, Lake, Mendocino, San Diego, and Los Angeles. We also conducted interviews with individuals from Santa Cruz and Marin counties. Our findings are based on the accounts of sixty-seven injection drug users as well as dozens of outreach workers, syringe exchange experts, governmental and nongovernmental experts on drug paraphernalia laws, and law enforcement officials.

While abuses similar to those documented here have been reported in other U.S. states, California was chosen because of its diverse policy environment, its national influence, and its relatively high population of injection drug users and people living with HIV/AIDS. Over one eighth of all reported AIDS cases in the United States have occurred in California. The state has been uniquely affected by HIV/AIDS since the first cases of AIDS-linked opportunistic infections appeared among gay men in Los Angeles in 1981. Since that time, injection drug use has become an important cause of HIV transmission in the state, yet California remains one of five states in the United States to forbid explicitly the nonprescription purchase and sale of sterile syringes.

Injection drug users interviewed for this report were identified with the assistance of local nongovernmental organizations, particularly syringe exchange programs. As such, they largely represent a portion of the drug-using community that is obtaining or has obtained HIV prevention services. The ability of the larger population of drug users to obtain sterile syringes may be more compromised than what is documented in this report. In all cases, the names of injection drug users have been changed to protect their privacy.

Before visiting California, Human Rights Watch sent written requests for interviews with the chief of police, sheriff, district attorney, or other law enforcement officials in all of the counties we visited (see Appendix A). Interviews were conducted, either in person or by telephone, with law enforcement representatives from San Francisco, Alameda, Lake, and Los Angeles counties, as well as with a representative of the Sacramento County District Attorney’s office. In Sacramento, California’s capital, Human Rights Watch interviewed public officials representing varying political views on recent legislative efforts to deregulate syringes. After completing its field research, Human Rights Watch conducted additional telephone interviews and sent written requests for interviews with sheriffs or chiefs of police in San Francisco, Los Angeles, Sacramento, and San Diego counties, as well as with Governor Gray Davis and the director of the State Office of AIDS (see Appendix A). It was not possible to schedule these interviews in time for publication of this report, but interviews are planned at the time of this writing with the Los Angeles county sheriff and with representatives from the governor’s office and the Office of AIDS.