A Fair Exchange

Miami-Dade’s syringe exchange program, now approved statewide, is reducing the spread of HIV and related diseases

Dr. Hansel Tookes III

Miami-Dade County is hardly alone in combating HIV, hepatitis C and other bloodborne diseases. Nonetheless, the county has had the unenviable distinction of being ranked No. 1 for new HIV infections in the United States.

But thanks to a persistent Miller School physician and a dedicated team of fellow physicians and medical students, the county is winning battles — and more important, saving lives.

Hansel Tookes III, M.D. ’14/M.P.H. ’09, was a third-year student in 2013 when he launched a five-year campaign to bring a clean syringe exchange program to Miami-Dade County.

“My grandmother was a nurse on campus and did public health work in the 1980s,” he said, recalling how she instilled a sense of public service in him early on.

Today, Dr. Tookes is an assistant professor of clinical medicine and the medical director of the Infectious Disease Elimination Act (IDEA) Exchange, which he founded in December 2016. What began as a pilot program, approved by the Florida legislature following the tenacious efforts of Dr. Tookes and like minded advocates, was expanded in May, allowing counties across the state to establish similar programs.

During the two years leading up to that monumental legislation, IDEA Exchange set up an on-campus clinic — housed in a pair of repurposed shipping containers — and dispatched a mobile unit to provide clean syringes to people who inject drugs, as well as related harmreduction health services. It is well known that HIV, hepatitis C and other blood-borne diseases are spread by used or shared syringes, a reality exponentially worsened by the nation’s deadly opioid epidemic.

While Miller School physicians and volunteer M.D./M.P.H. students ran the clinic and canvassed the streets, reaching more than 1,200 at-risk individuals, UM data analysts documented the program’s success. They verified a drop in improper syringe disposal in public spaces, a reduction in new cases of HIV and hepatitis C, and fewer drug overdoses and associated deaths, largely due to the distribution of thousands of doses of naloxone, the overdose-reversal agent.

“This is all about meeting people where they are,” Dr. Tookes explained. “When all is said and done in reducing HIV in Miami, UM will have played an enormous role.”

UNIVERSITY OF MIAMI MEDICINE
FALL 2019