There's concern among medical professionals and public health advocates that the increase in heroin users in New Jersey could lead to an increase in HIV cases from sharing contaminated needles.

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Axel Marrero, senior director of Policy and Prevention at Hyacinth AIDS Foundation in New Brunswick, said early on New Jersey's HIV epidemic was driven by injection drug use and the sharing of contaminated needles, so concern has remained about whether an increase in heroin addiction could lead to more instances of the disease being transmitted.

Marrero said while the implementation of syringe exchange programs several years ago in a handful of cities, including Jersey City, Patterson, Newark, Camden and Atlantic City, have helped stopped the spread of HIV, a statewide program is needed.

"We're cautiously concerned, but we do know that the syringe exchange programs, if those programs are fully funded and implemented across the entire state, we would be better equipped to be able to deal with any increase in heroin addiction," said Marrero.

Marrero said the number of HIV cases in areas his organization serves has remained steady.

"We still have cases of injection drug users turning up HIV positive. Has there been a significant increase? We haven't seen that yet. We have seen an increase in heroin addiction in smaller communities, verses some urban centers, but it's still prevalent in the urban centers, but we see a small increase in suburban centers as well," Marrero said.

Marrero explained that getting a needle exchange program is a lengthy process. Cities have to pass an ordinance to allow it and apply to the state and health department to run a syringe exchange program. Marrero said his organization would like to see the program in Trenton, New Brunswick, or maybe the Perth Amboy area.

"Every municipality and every city should have the option to be able to create a syringe exchange program and implement it," Marrero said.

In addition to helping stop the spread of HIV, Marrero said syringe exchange programs can also serve as a gateway to treatment, which he said has come a long way, thanks to extensive treatment modalities available today. Optimal patients, without mental health issues, who have stable housing and unrestricted access to medication, can live a normal life, according to Marrero.

"The community that we deal with are plagued with mental health issues, housing issues, issue of poverty and survival, race, homophobia, so it's not always easy to get a patient, a consumer living with HIV and AIDS needs to be the optimal patient, taking his medication, adhering 100 percent, faithful to the medications and to their doctor visits and therefore, they're undetectable. That's the goal we would like to achieve with everyone with HIV because there's a lot of barriers still standing in the way of that," Marrero said.

HIV is transmitted blood to blood and is extremely easy to contract through contaminated needles shared during drug use, according to Marrero. He added classic symptoms include massive fatigue, weight loss, night sweats, fever and diarrhea.

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