After years of fighting, AIDS prevention advocates have won two major but little-noticed victories - one in Harrisburg, the other in Washington - that experts say should reduce the transmission of diseases spread by drug addicts.

The omnibus appropriations bill that President Obama signed last week drops a long-standing ban on federal funding of needle exchange programs. And the Pennsylvania State Board of Pharmacy three months ago lifted the requirement for a prescription to buy syringes at a pharmacy, leaving New Jersey and Delaware as the only states still requiring a script.

Both actions had been delayed for years over fears that they could increase crime, despite mounting evidence that easing access to sterile syringes reduces transmission of HIV and hepatitis C without increasing drug addiction.

That can seem counterintuitive. But dirty needles are a leading source of HIV infection, and people in the field say so-called structural changes often are more effective than trying to change an addict's behavior. Philadelphia has ample reasons to participate; its HIV rate is three times New York City's, and is high even for a metro area.

Needle-exchange programs, in which addicts turn

See NEEDLES on A6