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HIV Alliance Services

HIV Alliance has testing and counseling available to the people in the Eugene community that are most affected by HIV/AIDS. They recommend that high-risk populations test for HIV every 3-6 months. An example of high risk people would be people who inject drugs and their partners. 

HIV Alliance's needle exchange program also offers free services and supplies to people who inject drugs which also helps in the fight against the spread of HIV. Services include: The Needle Exchange (One new needle for each used needle , with no limit), HIV and Hepatitis C Testing and Counseling (Free for people who inject drugs and their partner), Wound Care (Free medical attention for cuts and lesions for people who inject drugs), Hepatitis A and B Vaccinations (Free for people who inject drugs), Injection Supplies (Alcohol wipes and cotton for cleaner injection), Wound Care Kits (Bandages, gauze, tape, antibiotic cream, and alcohol wipes), Safer Sex Supplies (Condoms, lube, and a variety of other supplies), Biohazard Containers (Several different sizes of containers so that people can handle their needles safely), and most importantly Referrals to agency programs such as drug and alcohol detox and treatment, food programs, shelters, and case management.

HIV Alliance finds it important that we note Oregon state's law, which "prohibits the distribution of syringes to a minor. We ask that people who are under 18 do not exchange needles. People under 18 may use other harm reduction services. People can bring in other people's syringes" (HIV Alliance).

Special thanks to Jeff Nichols , This e-mail address is being protected from spambots. You need JavaScript enabled to view it the needle exchange coordinator at HIV Alliance.

541-342-5088 x 118

The Truth about Needle Exchange Prorams

Their is a background and history on needle exchange programs that most people are completely unaware of. As of June 2001 the Centers for Disease Control and Prevention (CDC) estimated that around one million individuals are living with HIV in the United States. They also reported that there had been 753, 907 actual cases of in the U.S. More importantly 25 percent of these cases are credited to risk factors related to the use of injecting drugs. On top of all that 36 percent of all AIDS cases are related to the use of injecting drugs. It has been Estimated by the Substance Abuse and Mental Health Services Administration that as around 2.4 million Americans are "injecting drug users."

There is an overwhelming amount of evidence that shows Needle Exchange programs work. They are preventing the spread of HIV and do not in any way promote substance abuse. Unfortunately, when I spoke to some of the faculty at HIV Alliance (Jeff), they informed me that until now congress had restricted the  use of federal funds for needle exchange programs. Around 1989, congress feared that needle exchange programs would encourage substance abuse by sending the message that injecting drugs is endorsed and promoted through the distribution of unused needles (Aids Action). This way of thinking in some ways still prevails although it has been proven untrue.

The U.S. Secretary of Health and Human Services (HHS) has the authority to say whether or not Needle exchange programs prevent the spread of HIV. In 1988, then secretary of the HHS certified that based on thorough research needle exchange programs (like the one at HIV Alliance) are an effective part of a strategy to prevent the transmission of HIV through the use of injectable drugs and does not encourage the use of illegal drugs.

According to Aids Action Organization, in 1983 the first needle exchange started in Europe. Amsterdam recognized that it would be near impossible to completely eliminate drug use, so they introduced the needle exchange program to reduce the spread of hepatitis B and HIV among people who inject drugs and their partners. an important thing to remember about needle exchange programs is that they are not needle distribution programs. A person must bring a used needle in to receive an unused needle. As of 2001 there were 113 needle exchange programs in the U.S., in addition to the needle exchange these programs also offer referrals for treatment and peer education and HIV prevention programs.

There have been numerous studies in the united states that have proved needle exchange programs are effective in reducing the spread of HIV through people who inject drugs. It has been shown in multiple cities that when a needle exchange program closed it led to an increase in sharing needles and other used equipment among people who inject drugs. These programs are important because they contribute to the 80 percent reduction of "risk behavior" (sharing equipment) among people who inject drugs. These programs also contribute to the 30 percent (or more) reduction in the transmission of HIV transmission all together.

AIDS Action reported that Dr. Don C. Des Jarlais has wrote multiple scientific reports that demonstrate over and over again that needle exchange programs prevent the transmission of HIV. He conducted his research in 7 different  locations and in each one he has found the same results, the programs reduce transmission and actually encourage people who inject drugs to seek treatment.

In short, needle exchange programs save lives. Incorporated as a part of a comprehensive HIV prevention strategy, these programs are effective, inexpensive and necessary. Also, they do not encourage the use of injectable drugs.

Utilitarianism

Utilitarianism is the idea that the morality of an action is determined only by its value in providing amusement or delight as summed among all sentient beings. Sentient refers to people who have the ability to have sensations or experiences. It is therefore a form of consequentialism, the idea that the moral worth of an action is determined by its outcome. The most influential philosophers who focused on this ideology were Jeremy Bentham and John Stuart Mill.

Utilitarianism has been explained in a number of different ways but most often by the phrase "the greatest good for the greatest number of people" (Bentham), and it is also known as "the greatest happiness principle". Utility is the good to be exploited, it has been defined by various philosophers as being joyful or pleasuring (rather than suffering or pain). It may also be described as a life stance, where happiness and pleasure are of ultimate importance. Utilitarianism can easily be contrasted with deontological ethics, as well as with other varieties of consequentialism.

Mill's essay is divided into five chapters. In these chapters he explains what utilitarianism is and some of the principles used to judge actions. In his second chapter, Mill formulates a single ethical principle, from which he believes all utilitarian ethical principles are derived. This is called the Greatest-Happiness Principle, it states that actions are right in proportion as they long as they promote happiness. Also, actions are wrong if the they seem to produce the opposite of happiness. Most importantly, it is not the agent's own greatest happiness that matters "but the greatest amount of happiness altogether" (Mill). Meaning, happiness for the majority. In fact, according to Mill, utilitarianism can only attain its goal, greater happiness, by "cultivating" the graciousness of individuals so that everyone can benefit from the honour of others. Mill also states utilitarianism is truly a "standard of morality" which uses the happiness of the greater number of people as its fundamental goal.

HIV Alliance wants to make other people's lives happier by preventing the spread of HIV. I believe that from a utilitarian point of view philosophers such as Mill would strongly agree with the Needle exchange program. Mill believes that n order to be truly happy we must focus our attention away from our own personal happiness and towards other objects and ends. For example, doing good for others as does HIC Alliance. The entire program is completely selfless. Most of the people running it do it without being paid. It is simply from the kindness of their own hearts.

























Works Cited:"Bentham, Jeremy." Columbia Electronic Encyclopedia, 6th Edition, (2009): 1.


Braybrooke, David. "The Relation of Utilitarianism to Natural Law Theory." Volume 12, Number 3, 2003, 12.3 (2003): 43-49.


Anomaly, Jonny. "Nietzsche's Critique of Utilitarianism." Issue 29, Spring 2005, 29.1 (2005): 1-15.

More on Deontological Perspective

Moral absolutist believe that certain actions are absolutely right or wrong, no matter what the consequences or the intentions behind them. We must also keep in mind that there is a definite difference between moral absalutism and consequentialism. Consequentialism, once again, is the deontological perspective according to which the “rightness” of an action is determined by the consequences that follow. There are deontologists who are also moral absolutists and they consider it to be true that some actions are wrong no matter what consequences follow from them. For example, Immanual Kant, he believes that the only definite good thing is a good will, and so the only determining factor of whether an act is ethically right is the will, or reason of the person doing it. If the person is acting on a bad maxim, like “ I will lie to this woman,” then the act they commit is wrong, even if some good consequences come of it.

Moral absolutist are hard to figure out. They believe that certain actions are wrong not matter what the consequences (good or bad). To my best knowledge I believe that moral absolutists would find HIV Alliances program to be morally wrong. Moral absolutists most likely find the injection of illegal drugs to be morally wrong and would find that giving these people clean needles, even if it is for a good cause, is also morally wrong.

Deontological Perspectives

We know and understand the purpose of HIV Alliance's Needle Exchange program. They want to prevent the spread of HIV through people who inject drugs and their partners. In order to do this they exchange used needles for unused needles. Now we will be looking at it from a deontological perspective.

The deontological perspective is a method of ethics that judges the morality of an act rooted in the action's devotion to a rule or rules. Deontological ethics are often compared to consequentialist or teleological theories, according to which the “rightness” of an action is determined by the consequences that follow.

Consequentialists would agree that HIV Alliance's program is morally okay, but if this program were to lead to the death of another person they would find it unmoral and be against it. If the Consequentialists looked at only the good consequences such as stopping the spread of HIV, it would most definitely be morally accepted. According Kant, whom believes in good will, HIV Alliance's program is very highly accepted without a doubt. Their intentions are only to help, and do good unto others.

According to Davis Alm,

"a defense of deontological restrictions need not

resort to what I call the 'Good/Bad asymmetry',

according to which it is morally more important

to avoid harming others than to prevent just such

harm. I replace this paradoxical asymmetry with

two non-paradoxical (if also non-obvious) ones."

These are the following: (1) We should treat an act of preventing harm to persons exactly as that (as a harm prevention), instead of as the causing of a benefit. Also, we should treat an action that does cause harm just as such (as harm causing), rather than as "the prevention of a benefit". (2) It is morally more important "not to cause harm than to cause benefit" (Alm).

I personally consider The Alliance's needle exchange program to be a "harm prevention program." The program is preventing more people from getting HIV. The organization has absolutely no intention of hurting anyone. I claim that Alm would definitely agree with that statement, along with many consequentialist.

I will continue on this subject and more, Thank you!

Works Cited

Alm, David. "Deontological Restrictions and the Good/Bad Asymmetry." Journal of Moral Philosophy, 6.4 (2009): 464-481.

Needle Exchange and Double Effect Doctrine

Volunteering to give people who inject drugs a clean needle to do so with is not the most logical thing according to some people. Most would have their fist instinct be to take away anything that might promote the use of inject-able drugs. HIV Alliance in Eugene, Oregon has created a needle exchange program that I will be directly tying into the doctrine of the double effect. Instead of using this doctrine to look at the matter of increased death alone, I will also be using it to look at increased harms.


The goal of the needle exchange program at HIV Alliance is to reduce the spread of HIV through people who inject drugs and their partners. This means for every used needle a person brings in they get one unused needle. The first question someone might ask is, " is this program promoting the use of inject-able drugs in the community?" Also, "What if the access to so many unused needles leads to more people who inject drugs dying, or more people injecting drugs altogether?" The main point here is that these things may be possibilities but are in no way the direct  intention of the program.


According to the doctrine of the double effect as explained by Philippa Foot, the needle exchange program at HIV Alliance applies perfectly to the double effect. The intention of HIV Alliance's program is to stop the spread of HIV, not to kill people who inject drugs, the other effects would be found completely unfortunate and unintentional.  


 This idea is a bit different than that of abortion. This is why I will bring up another one of Foot's examples. "Direct" and "oblique" intention are two things that are key in determining whether or not the needle exchange program would be rejected by the double effect. Direct intention would be if grave diggers purposely sold piousness oil to people in order to create more deaths. Death of more people would be intentional in this case. On the other hand their are merchants that are also selling this same piousness oil, while they may not intend to kill people they know that people will die if they use it. The merchants in this case would still be held accountable for the same accusations as the gravediggers making their intent "oblique," but they are none the less guilty.


My argument is that HIV Alliance's program is unlike the gravediggers and the merchants. They do not know for a fact that trading used needles for unused needle would lead to the deaths of people who inject drugs. It is only a possibility which makes the intentions of HIV Alliance neither direct or oblique. It is accepted under the doctrine.