Senior Fellow in Religion and Public Policy makes 'The Conservative Case for Needle Exchange'

William Martin, Harry and Hazel Chavanne Senior Fellow in Religion and Public Policy at the James A. Baker III Institute for Public Policy at Rice University, has once again delivered a stunning commentary on why needle exchange in Texas and why now more than ever. The article in today's Texas Tribune, "The Conservative Case for Needle Exchange," reminds Texans that needle exchange programs are an essential component in addressing addiction, helping people seek treatment for their addiction, and saving the state piles of money while decreasing the burden of disease.

In 2007 and 2009, Senator Bob Deuell championed syringe exchange in the Texas Senate. Martin recalls Deuell's support for syringe exchange as grounded in not only science, but also in compassion and Christianity.

'Sen. Bob Deuell, a conservative Republican and a practicing doctor, sponsored similar bills in both 2007 and 2009. "At one time," he recalled, "I was opposed, but I looked at the data. When people have disagreed with my vote, I've shown them the data and asked them, 'How could I argue with that?'" A fiscal conservative, Deuell also noted that syringe exchange makes good economic sense: "It costs us a fortune to treat HIV and hepatitis C. It's breaking the budget."

Deuell's support of needle exchange does not rest on science and economics alone. "I look at it from the Christian viewpoint," he said. "What would Jesus do? We need to show compassion and try to help. [Addicts] are God's children, too. When they need new needles, this puts them in touch with someone who might reach them. The very act of handing them clean needles says, 'Your life has value to me. I want you to know that we care about you. When you want to get off, we're here to help you.' If they're in a back alley, using a dirty needle, there's no chance of that."'

States that offer syringe exchange programs have significantly reduced the incidence of HIV among injection drug users.

'A Johns Hopkins study of the Baltimore City Needle Exchange found that, after six years in operation, the incidence of HIV in Baltimore decreased by 35 percent overall and 70 percent among the approximately 10,000 participants in the program. Even more striking, epidemiologist Don Des Jarlais, director of research at New York’s Beth Israel Medical Center and a leading expert on syringe exchange, reports that the incidence of new HIV infections among injecting drug users in New York City has dropped to less than 1 percent per year. "We appear," he said, "to be very close to eliminating injecting-related transmission in a city with over 100,000 injecting drug users." '

Thank you Mr. Martin for presenting the facts and reminding us that syringe exchange as disease prevention has had strong support, from Republicans, Democrats and Christians alike, here in Texas.

Read full article.

Representative Susan King signs on to HB 117 as Joint Author

Appropriations, House Administration (Procedural), and Public Health Committee member Susan King has signed on to House Bill 117. The Primary and Joint Authors of HB 117 reaffirm that providing counties with the option of allowing disease prevention outreach programs that address the consequences of injection drug use at the point of preventing further transmission of deadly disease remains an issue with strong bipartisan support here in Texas:

• Primary Author, Rules and Resolutions (Procedural) Chair Ruth Jones McClendon; and
• Joint Authors Appropriations Subcommittee on Article II Chair Doctor John Zerwas,
• County Affairs Chair Garnet F. Coleman, and
• Appropriations, House Administration (Procedural), and Public Health Committee member Susan King.
  

A sincere thank you to Representative King, a Registered Nurse and staunch supporter of disease prevention outreach programs!

Representative Garnet Coleman signs on to HB 117 as Joint Author

County Affairs Chair and Public Health Committee member Garnet Coleman has signed on to House Bill 117, by Representative Ruth Jones McClendon. Representative Coleman has been a strong supporter and champion of HIV disease prevention outreach programs. A heartfelt thank you to Representative Coleman!

HB 117 referred to House Committee on Public Health

House Bill 117, by Representative Ruth Jones McClendon, received its first reading and was then referred to the Committee on Public Health. Representative John Zerwas, Public Health committee member, signed on two weeks ago as joint author. Representative Zerwas, along with five other members of the current Committee on Public Health (Vice Chair Elliott Naishtat, Chair Garnet Coleman, Chair Veronica Gonzales, Representative Susan King, and Chair Vicki Truitt), voted in favor of the same piece of legislation when it came before the committee last session.

New Mexico Department of Health reduces disease through needle exchange program

The New Mexico Department of Health's needle exchange program has been tasked with reducing new cases of AIDS in New Mexico since 1998. The New Mexico Harm Reduction Act was passed in 1997 to reduce the spread of blood borne diseases that are transmitted by the reuse of needles and/or syringes. In addition to promoting public health by reducing the number of cases of deadly disease, such as HIV and hepatitis C, the program is keeping communities safer by minimizing the number of improperly discarded syringes found in parks and playgrounds. As part of its harm reduction and needle exchange services the Department of Health also offers hepatitis screening, hepatitis A and B vaccinations, overdose prevention training, health promotion and disease prevention education, primary medical care and drug treatment referrals.

The purpose of the program according to Dave Daniels, an HIV educator in Las Cruces, New Mexico is 'first is to get possible infected needles out of the community and the second is to develop trust with the participants so when they are ready to start fighting the addiction, they have a person to turn to whom they trust.'

New Mexico has also had extensive support from law enforcement. A powerpoint presentation by Sonny Leeper, former Captain of the Albuquerque Police Department, explains the New Mexico Harm Reduction Act of 1997 and explains how needle exchange helps protect police officers from the risk of needlestick injury.

Read more about needle exchange in New Mexico here.

HB 117 picks up a Joint Author

Representative and physician John Zerwas signs on to House Bill 117, by Representative Ruth Jones McClendon. Representative Zerwas worked hard with fellow members of the House Committee on Public Health last session to strengthen similar legislation, which was successfully voted out of committee. Thank you again Representative Zerwas!

House Bill 117 leads into 82nd legislative session

At least one syringe exchange bill has been pre-filed leading up to the 82nd Texas legislative session. House Bill 117, filed by Representative Ruth Jones McClendon, would provide local authorities (in Texas counties with a population over 300,000) the option of authorizing disease prevention outreach programs, such as syringe exchange. This would allow community-based and faith-based organizations to provide compassionate, evidence-based outreach services that reduce blood borne disease transmission among individuals, and their loved ones, struggling with drug addiction here in Texas. In addition to reducing disease, syringe exchange programs make communities safer through proper disposal of used syringes, reducing rates of drug use, reducing the number of needle stick injuries to first responders and law enforcement, providing referrals to drug treatment, and increasing the likelihood of successful treatment outcomes. See full text of bill here.

Legislature has easy way to cut spending in Texas

Check out the Op-ed on syringe exchange in today's issue of the Houston Chronicle. An excerpt:

"Syringe exchange is life preservation, not drug support. Drug addiction is painful and costly enough. If we know how to keep HIV and HCV out of the picture, it would be irresponsible and expensive to continue not to do so here in Texas. Evidence-based interventions that reduce HIV transmission, such as syringe exchanges, are vital to the health and well-being of all Texans."

Read more here.

UN Reference group on HIV and injecting drug use calls for evidence based approach

The 2010 Consensus Statement of the Reference Group to the United Nations on HIV and Injecting Drug Use calls for an evidence-based approach to control the spread of HIV among people who use drugs and their non-using partners. The Reference group identifies key issues and makes recommendations to respond to the dual crisis of injection drug use and HIV.

The Statement calls for a human rights, comprehensive, evidence-based approach that includes:

1. Needle and syringe programmes (NSPs)

2. Opioid substitution therapy (OST) and other drug dependence treatment

3. HIV testing and counselling (T&C)

4. Antiretroviral therapy (AR T)

5. Prevention and treatment of sexually transmitted infections (STIs)

6. Condom programmes for IDUs and their sexual partners

7. Targeted information, education and communication (IEC) for IDUs and their sexual partners

8. Vaccination, diagnosis and treatment of viral hepatitis

9. Prevention, diagnosis and treatment of tuberculosis (TB)

The report urges legislators to remove legal barriers to syringe exchange and calls for a cooperative effort among law enforcement and health workers in order to increase access to HIV prevention, treatment and care.

Needle exchange in Iran

Tina Rosenberg's opinion piece in the New York Times, "An Enlightenend Exchange in Iran," paints a compelling portrait of the power of treating drug abuse as health policy. Iran has successfully averted an HIV nightmare by aggressively embracing harm reduction and needle exchange. In Iran, 68% of HIV infections come from sharing a contaminated syringe. Despite its reputation as one of the most repressive regimes in the world Iran has adopted a policy of treating drug abuse as a disease, not a crime. And as health policy, drug abuse "is a health issue — not just for drug users, but for everyone" (see the follow up article, "How Iran Derailed a Health Crisis").

An excerpt from "An Enlightened Exchange in Iran":

"The rate of new H.I.V. infections in Iran rose until 2005, and has dropped ever since. A top drug control official, Saeed Sefatian, said in 2008 that 18 percent of injecting drug users were H.I.V.-positive, but estimated that if it weren’t for harm reduction, that number would have been 40 percent. New infections among drug users have continued to drop. Surveys at sentinel sites in pre-natal clinics have not yet turned up not a single pregnant woman with H.I.V. (UNAIDS report, p. 97) ─ an excellent indication that the epidemic has been contained.

By pointing out the success of this program, I do not mean to endorse Iran’s prisons, where political dissidents are being tortured. Nor does Iran’s modern approach to harm reduction redeem the government’s stone-age approach to just about everything else. The same ayatollah who told judges not to get in the way of harm reduction was the man who closed dozens of newspapers. The important point here is that even a theocracy as repressive and rigid as Iran ─ the anti-Amsterdam ─ managed to create policies that have likely saved the country from an AIDS and drug disaster."

If Iran can, why can't Texas?

World AIDS Day 2010

Today is World AIDS Day. The current World AIDS Day Campaign theme is Universal Access and Human Rights. Universal access includes the right to care, treatment and prevention. The Harm Reduction Coalition issued this World AIDS day statement:

"Responses to both the domestic and the global HIV/AIDS epidemics among people who inject drugs face similar challenges: drug-related stigma that underpins repressive policies, lack of political will, and limited funding. Moreover, access to care and treatment remains limited for HIV+ drug users, who face multiple obstacles to obtaining antiretroviral therapy along with the associated health risks of hepatitis C, tuberculosis, and overdose. The 2010 World AIDS Day theme of Universal Access and Human Rights has a special urgency for people who use drugs, signifying an unrealized promise and demanding immediate action. The Harm Reduction Coalition calls upon governments and civil society to recommit to making Universal Access and Human Rights a reality for all people who use drugs as a necessary foundation for ending the HIV/AIDS epidemic."

Dr. David Lakey, Commissioner of the Texas Department of State Health Services reminds us in a special article to the Star-Telegram that 1 out of every 387 Texans are HIV-infected. The rate of new HIV infections in Texas is stable, but not decreasing. In addition, Texas is a late to diagnose state: 1 in 3 people diagnosed with HIV will progress to AIDS within a year. Dr. Lakey urges 'know your status; protect each other.'

Syringe exchange is the second most effective intervention at reducing HIV transmission, next to only PMTCT (prevention of mother-to-child transmission). Yet, Texas continues to remain one of the only states in which access to sterile syringes is prohibited, which gets in the way of preventing new infections and saving lives. Please take a moment today to remember loved ones lost and continue to commemorate them by supporting sensible disease prevention programs that will protect others from needless pain and suffering.

Legislative briefing draws experts from across the U.S.

Today's briefing on syringe access occurred on the eve of the 8th National Harm Reduction Conference, the nation's leading gathering of harm reduction enthusiasts and experts from around the globe. A panel of six speakers convened in the Texas Capitol Legislative Conference Center to reinforce the importance of syringe access as a successful disease prevention tool that Texas has gone far too long without and paid too high a price.

Don Des Jarlais (pictured above), Director of Research at Beth Israel Medical Center, spoke about the safety and efficacy of syringe exchange. He is a leading researcher on AIDS and injection drug use. He reminded listeners that syringe exchange programs offer a low cost and cost effective way to reduce the burden on the public system of treating the expensive twin epidemics of HIV and hepatitis C.

Allan Clear, Executive Director of the Harm Reduction Coalition and a nationally and internationally renowned harm reduction expert, spoke about the decision of the U.S. Congress to end a twenty year ban on the use of federal funds for syringe exchange in December 2009. He noted that cities such as New York, that offered syringe exchange early on, were able to avert large-scale HIV epidemics in drug users. He reminded us that while there may have been reason to be skeptical about syringe exchange twenty years ago when no one knew or understood what these programs were, we now know that syringe exchange is the second most scientifically proven effective HIV prevention method, next to only prevention of mother-to-child transmission.

Ruthie Burich, Prevention Specialist at AIDS Resource Center of Wisconsin (ARCW), spoke about her experience providing syringe exchange services and HIV testing and counseling to injection drug users in a state that has successfully reduced rates of HIV in this high risk population. ARCW operates Lifepoint, one of the nation's leading statewide needle exchange programs. Lifepoint serves clients and families in eleven cities throughout the state. Ruthie explained that programs not only offer access to sterile syringes, but also often provide primary health care services and referral to drug treatment.

Heather Edney, a marketing consultant from Southern California shared how syringe exchange programs saved her life after she became addicted to drugs at the age of fifteen and throughout her high-achieving teenage and college years. She explained how access to sterile syringes kept her from getting HIV, hepatitis C and other deadly blood borne infections until she was ready and able to successfully seek drug abuse treatment services. She pointed out that one syringe may cost as little as 0.08 cents, which seems reasonable compared to the price of doing nothing.

Jill Rips (left), Deputy Executive Director at San Antonio AIDS Foundation, has supported establishing syringe exchange programs in San Antonio where rates of hepatitis C and AIDS in injection drug using populations remain alarmingly high. Clients in Texas who continue to struggle with addiction and disease are left with very few options and resources, despite a willingness to protect themselves and loved ones from further transmission of HIV and other infections.

Tracey Hayes, Field Organizer at the ACLU of Texas and Project Director of The Access Project for over six years, spoke about the success of syringe exchange legislation in the 81st legislative session. She reminded the audience that the issue continues to bring together parties on both sides of the aisle and maintains a strong bipartisan coalition of supporters who support these sensible programs that save lives and taxpayer dollars.

A very special thank you to our panelists and guests today! Here's to hoping the legislature is poised and ready in 2011 to pass legislation that will immediately begin saving the public system from continuing to pay millions of dollars in expensive emergency room visits and chronic HIV and hepatitis C treatment costs, which is where drug users end up when we choose to do nothing.

8th National Harm Reduction Conference comes to Texas Nov. 18th-21st

Dear friend,

As we reflect upon history made by the Texas Legislature in 2009 and prepare for the 2011 82^nd Legislative Session, we are happy to report that the ban on the use of federal funds for syringe exchange programs has finally come to an end in the interim. As proposed in 2009, Texas Senate Bill 188 would have allowed local options for disease prevention programs including syringe exchange. Senate Bill 188 made history by making it farther through the legislature than any similar legislation filed since 1993, inspiring the largest bi-partisan coalition of House and Senate bill authors and supporters ever on this issue, and bringing together an unprecedented and diverse coalition of supporting organizations from around the state. We are optimistic that in 2011 Texas will follow the lead of the U.S. Congress and keep pace with the nation in allowing programs that effectively save lives and taxpayer money.

As of 2008, 14,147 Texans were living with HIV/AIDS as a result of having acquired this deadly disease directly from injection drug use, or indirectly as a partner or child of an injection drug user. An estimated 300,000 Texans are infected with hepatitis C virus (HCV), the leading cause of liver disease. Injection drug use is the number one risk factor for HCV. Syringe exchange programs safely and effectively reduce the transmission of these diseases and save the state from bearing the burden of millions of dollars in treatment costs.

Austin is fortunate to host the 2010 8^th National Harm Reduction Conference, Harm Reduction Beyond Borders, November 18 - 21. The conference takes place at the Renaissance Hotel at 9721 Arboretum Boulevard. Please visit the website for further details (www.8thnationalharmreductionconference.com). We invite you to join like-minded Texans at a special conference session hosted by The Access Project, Texans Mobilizing for 2011: Syringe Exchange in the 82nd Texas Legislative Session, on Thursday, November 18^th, 2010 at 7:15 p.m. The Access Project looks to bring stakeholders to the table to organize and plan advocacy action steps for the upcoming legislative session.

For further information on the history, safety and effectiveness of these lifesaving programs please visit The Access Project website (www.texasaccessproject.org) or contact Jenny Panzo, Education Coordinator at The Access Project, at jenny@texasaccessproject.org. The Access Project looks forward to seeing you at the conference!

Kind regards,

Jenny Panzo, MPH

Legislative briefing at the Capitol

Join The Access Project for an interim legislative briefing at the Texas Capitol as we prepare for what is sure to be an extra fun-filled and jam-packed 82nd Legislative Session. Let's make sure that with redistricting, immigration and a budget crisis on the table disease prevention programs don't get left behind!

Live saving policy well within reach

The Texas Legislature adjourned Monday evening without passing SB 188, which would have allowed local options for setting up disease prevention programs including syringe exchange. While the final hurdle was not passed, many legislators let us know they believe it would have had the votes to pass the House floor if it had been called up for a debate and vote.

Senate Bill 188 made Texas History this year by:

• making it farther through the legislative process than any similar piece of legislation filed since 1993;

• inspiring the largest bi-partisan coalition of House and Senate bill authors and supporters ever for this issue; and

• bringing together an unprecedented and diverse coalition of supporting organizations from around the state.

So what now?

The Texas Legislature will not meet again for a regular session until January, 2011. However, over the summer House Speaker Joe Straus will be considering the issues he will direct House Committees to study during the interim. In order for House members and the public to have an even better understanding of the need for allowing syringe exchange programs to operate throughout Texas, it would be wonderful to see Speaker Straus direct the Public Health Committee to investigate the issue further and to provide a space for regional feedback on the issue from the public.

The committee could review the effectiveness of current efforts in Texas to curb the spread of HIV and hepatitis B & C among Texas' injection drug using population, and provide recommendations for how these efforts could be improved in order to save lives and reduce indigent health care costs to the state. Committee members might even be directed to travel to a state such as Maryland to visit longstanding successful syringe exchange programs where they can witness firsthand the measurable benefits of allowing such programs.

What are your thoughts for next steps to educate Texans about the importance of allowing syringe exchange programs in Texas? We would appreciate hearing your feedback. Feel free to leave a public comment or email your thoughts to noelle@texasaccessproject.org.

SB 188 waiting on General Calendar

The Texas House of Representatives is delaying the debate and vote on Senate Bill 188 for reasons unrelated to the bill, and we are waiting every day to see if the bill will be heard before the Tuesday deadline.

Click here to see the bi-partisan list of authors and sponsors, and to learn more about what the legislation would allow if passed.

Click here to read the House Research Organization's updated bill analysis for SB 188.

HIV exploding in rural Texas but SB188 will not offer local options for rural areas

The Abeline Reporter News reported this week that the city has seen a drastic rise in HIV cases, which is partially due to an increase in injection of methamphetamine. According to Kevin Owens, director of medical services at AIDS Resources of Rural Texas:

"Intravenous methamphetamine abuse in rural areas, which exploded 10 to 12 years ago, can account for new cases, Owens said.

"'A lot of people are now coming in with HIV and hepatitis C,' he said, saying that in his earlier career in rural health in Ballinger he was surprised by the prevalence of such drugs in rural communities."

These increases in cases cost tax payers as well as private health insurance pools. Mr. Owens discussed the cost of these services to taxpayers:

"The gains that have come do come at a cost, he said, with treatments costing a minimum of $1,400 a month.

"But the majority of patients ARRT sees get their medications through the state- and federally-funded Texas HIV Medication Program, paying only a $5 co-pay."

The current version of SB188 only allows local options for disease prevention in Texas counties with over 300,000 residents. Abeline is in Taylor County, a county with 126,555 residents, so the bill will not allow Abeline to choose to prevent these diseases using proven syringe exchange programs.

In its current form, SB188 will only allow the local option in 12 Texas counties: Bexar, Cameron, Collin, Dallas, Denton, El Paso, Fort Bend, Harris, Hidalgo, Nueces, Tarrant and Travis.

Learn more about HIV in rural Texas here and here.

SB188 set on House Calendar for tomorrow

SB188, the bill that allows local options to set up publicly or privately-funded disease prevention programs including syringe exchange, has been set on the House Calendar for tomorrow, Thursday, May 21. If the House is unable to reach the bill tomorrow, they are likely to reach the bill on Friday.

SB188 doesn't mandate or fund any program - it simply gives local urban areas another option for life-saving disease prevention. The bill will save millions of state and local tax dollars, save first responders and other innocent victims' lives, and save lives within the main affected community. According to the Texas Department of State Health Services, the programs do not increase drug use but do increase the use of drug treatment.

SB188 will:

• allow local entities to authorize a privately-funded or local tax-funded program in their area,
• offer education and a path to treatment and recovery to every client of the program,
  
• require programs to exchange a dirty syringe for every safe and clean one they provide,
• require monitoring and reporting of each program so we know they are effective, and
  
• only apply to counties with over 300,000 residents.

Please be sure that your friends who are interested in this legislation are aware that the Texas House may debate the issue tomorrow. You can always find more information on this blog and this website. Thank you and stay tuned!

More legislators and organizations support SB188 as it moves to House Calendars Committee

With two weeks left in session, SB188 is on its way to the Calendars Committee. The new bill language, fiscal note and bill analysis is available here. The list of bill authors, sponsors and cosponsors has grown and now includes:

• Sponsor County Affairs Chair Garnet Coleman;
• Joint Sponsors Rules and Resolutions Chair Ruth Jones McClendon,
• Representative Solomon Ortiz, Jr.,
• Appropriations Health & Human Services Subcommittee Chair (and Doctor) John Zerwas,
• SB188 Public Health Subcommittee Chair Susan King; and
• Cosponsors Public Health Vice-Chair Elliott Naishtat, and
• Technology, Economic Development and Workforce Chair Mark Strama.

These House members join a strong list of authors in the Senate:

• Primary Authors Health & Human Services Vice-Chair and Senate Republican Caucus Chair (and Doctor) Robert "Bob" Deuell,
• Veterans Affairs & Military Installations Chair and Senate Democratic Caucus Chair Leticia Van de Putte; and
• Coauthors Finance Vice-Chair Juan "Chuy" Hinojosa,
• Jurisprudence Chair Jeff Wenworth,
• Intergovernmental Relations Chair Royce West, and
• Higher Education Chair Judith Zaffarini.

The official witness list for the House Public Health Committee hearing is available here. Organizations testifying or registering in favor of SB188 include:

• Texas Medical Association
• Texas Hospital Association
• Texas Nurses Association
• Texas Pediatric Society
• Texas Academy of Family Physicians
• Coalition for Nurses in Advanced Practice
• Scott & White Center for Healthcare Policy
• Harris County Healthcare Alliance
• Houston Area Immunization Partnership
• CHRISTUS Santa Rosa Health Care
• Legacy Community Health Services
• Bexar Area Harm Reduction Coalition
• South Texas Substance Abuse Recovery Services (STSARS)
• County Judges & Commissioners Association of Texas
• Bexar County Commissioners Court
• Trinity County
• League of Women Voters
• Texas IMPACT
• James A. Baker Institute for Public Policy, Rice University
• Texas Advocacy Project
• Retired Bexar County Constable
  
• St. Mark's Episcopal Church

Organizations that could not attend the hearing but submitted letters and resolutions in support include:

• Combined Law Enforcement Associations of Texas (CLEAT)
• Austin Police Chief
• Nueces County Sheriff
• Cameron County Sheriff
• Nueces County Constable Precinct 1
• Nueces County Constable Precinct 2
• Community Health Outreach Work to Prevent AIDS
• AIDS Services of Austin, Inc.
• American Civil Liberties Union of Texas
• Hepatitis C Advocate Network
• Latino HIV Task Force
• San Antonio AIDS Foundation
• Texas Academy of Internal Medicine

We will update you when the House Calendars Committee has acted. In the meantime, don't miss the excellent Grits for Breakfast coverage after the House hearing. Stay tuned!

Powerful coalition endorses federal syringe exchange legislation

Federal law authorizes syringe exchange programs - many organizations would like to see the federal government fund the programs also. In a letter to President Obama, the Hepatitis C Appropriations Partnership (HCAP) requested federal support for syringe exchange programs.

This impressive coalition of organizations all agree with the Texas Department of State Health Services that there is overwhelming scientific evidence that the transmission of HIV through injection drug use can be decreased significantly by needle exchange programs, and that they do not increase drug use. At this time, the group includes:

ACT UP Philadelphia
Agape Center, Woonsocket, RI
AIDS Action Baltimore
AIDS Action Committee of Massachusetts
AIDS Action Council, Washington, DC
AIDS Alabama, Birmingham, AL
AIDS Community Research Consortium (ACRC), Redwood City, CA
AIDS Community Research Initiative of America, New York, NY
The AIDS Institute, Washington, DC
AIDS Foundation of Chicago
AIDS Support Network, San Luis Obispo, CA
AIDS Treatment Data Network, New York, NY
Alert Health, Inc., North Miami, FL
Alliance for Saving Lives, San Francisco, CA
American Liver Foundation
Arizona Hepatitis C Coalition
Asian Health Coalition of Illinois
Asian Liver Center at Stanford University
Association of Asian Pacific Community Health Organizations
Bangor STD Clinic, Bangor, ME
CAB Health & Recovery Services, Lynn, MA
California Hepatitis Alliance (CalHEP)
Caring Ambassadors Program, Inc., Vancouver, WA
Cascade AIDS Project, Portland, OR
Chicago Recovery Alliance
Community Health Action of Staten Island
Community HIV/AIDS Mobilization Project
Discovery House: Bangor
Division of Gastroenterology and Hepatology, Weill Cornell Medical Center, NY
Drug Abuse Alternatives Center, Santa Rosa, CA
Florida Association of Public Health Nurses (FAPHN), Inc. Foundation for Healthy Living , Latham, NY
Georgia Doty Health Education Fund, IL
Greenview Hepatitis C Fund, Ann Arbor, MI
Harlem United Community AIDS Center
Harm Reduction Center of Southern Oregon
Harm Reduction Coalition
Hepatitis Support Network of Hawai’i
hepCmeditations project, Seattle, WA
Hep C Advocate Network, Inc. (HEPCAN), Longview, TX
HCV & HBV Support Group / O'Connor Hospital, Delhi, NY
H.E.A.L.S of the South, Hepatitis Education Awareness and Liver Support, Tallahassee, FL
Hep C Connection, Denver, CO
Hepatitis B Foundation
Hepatitis C Association, Scotch Plains, NJ
Hepatitis C Support Group – NYU Medical Center
Hepatitis C Support Project/HCV Advocate, San Francisco, CA
Hepatitis Education Project, Seattle, WA
Hepatitis Foundation International
Hepatitis Outbreaks’ National Organization for Reform (HONOReform)
HIV/AIDS Services for African Americans in Alaska, Anchorage, AK
HIVictorious, Inc., Madison, WI
HIV Alliance, Eugene, OR
Immunization Action Coalition
Latino Organization for Liver Awareness ( L.O.L.A.), New York, NY
Liver Health Today, Houston, TX
LiverHope, Minnetonka, MN
Los Angeles Gay & Lesbian Center
Lower East Side Harm Reduction Center, New York, NY
Maryland Hepatitis C Action, Annapolis, MD
Maryland Viral Hepatitis Task Force, Baltimore, MD
Maui AIDS Foundation
Mission Neighborhood Resource Center, San Francisco, CA
Mo Hepatitis C Alliance
National Alliance of State and Territorial AIDS Directors
National Association of People With AIDS (NAPWA)
National Coalition of STD Directors
National Task Force on Hepatitis B: Focus on Asian and Pacific Islander Americans
National Viral Hepatitis Roundtable
New York Harm Reduction Educators Inc.
New Mexico Hepatitis C Alliance
North Shore Health Project, Gloucester, MA
NYC AIDS Housing Network (NYCAHN)
Ohio Asian American Health Coalition
OraSure Technologies, Inc.
Piedmont HIV Health Care Consortium, Durham, NC
Point of Change, Inc., Detroit, MI
Positive Health Project, Inc., New York, NY
Project Inform, San Francisco, CA
PROYECTO SOL, Philadelphia, PA
San Mateo County AIDS Community Board, San Mateo, CA
Southern AIDS Coalition
St. Ann’s Corner of Harm Reduction, Bronx, NY
Status C Unknown, Inc., Medford, NY
Test Positive Aware Network (TPAN), Chicago, IL
Title II Community AIDS National Network, Washington, DC
Treatment Access Expansion Project
Treatment Action Group, New York, NY
The Virology Treatment Center, Maine Medical Center, Portland, ME
Upstate New York Hepatitis Awareness Project, Delancey, NY
Utah Department of Corrections
Vertex Pharmaceuticals Incorporated
Virginia Hepatitis Education and Training Center, Springfield, VA
Visionary Health Concepts
VOCAL-NY Users Union
Wabanaki Mental Health, Bangor, ME
Weill Cornell Medical Center
Western Maine Community Action Health Services, Lewiston, ME
Wilson Resource Center, Arnolds Park, IA
Wings for Life