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Dale Helvig Resident, Santa Ana CA 92706 April 16, 2024 Mayor Amezcua and Santa Ana City Councilmembers City of Santa Ana 20 Civic Center Plaza, 81" Floor Santa Ana CA 92702 Subject: Item 27 Needle Give Away or Needle Distribution Program? I am adamantly against what I'll call the Needle Give Away or Needle Distribution Program and fully support the proposed resolution by the City Council announcing its opposition to the establishment of a Needle Exchange Program in the City. Furthermore, It is my understanding the Harm Reduction Institute (HRI) is using data created by the OC Heath Care Agency to determine the cities that have the highest rate of new HIV cases each year, which I believe is flawed I believe the methodology used by the OC Heath Care Agency is flawed in determining which city has the "highest need" for such a drastic program. A city of 30,000 with 9 new HIV cases would have a rate of 30.00, yet it is not identified as an issue. Santa Ana has a reported population of 310,555, which we all know is extremely low and a reported new rate of 14.9. This is the highest reported rate in OC. FACT 1 (from the OC Heath Care Agency Fact sheet): At the end of 2022, there were 6,916 persons living with HIV (PLWH) in Orange County3 who are aware of their HIV status and an additional estimated 1,288 persons who are unaware of their HIV status. The Centers for Disease Control and Prevention (CDC) calculation methodology estimates that 84.3% of PLWH know their status. Therefore, the total estimated number of PLWH in Orange County is 8,204.` Footnote 4: The total number of persons estimated to be living with HIV is based on the Centers for Disease Control and Prevention calculation methodology updated in 2021. The calculation is the number of persons known to be living with HIV (6,916) divided by 0.843. The difference between this calculation (8,204) and 6,916 is the additional number of persons estimated to be living with HIV but are unaware of their diagnosis (1,288). FACT 2 (from the OC Heath Care Agency Fact sheet): Rates are not calculated for cities where population estimates are unavailable or there were fewer than ten cases reported. FACT 1 is appropriate and logical, FACT 2 is not. County records show positive results. The OC Heath Care Agency takes into consideration individuals living with HIV but are unaware of their diagnosis. Likewise, we should be fully transparent about the new HIV case for every city in Orange County. Use realistic population numbers and don't exclude a city based on an arbitrary threshold for reported cases. Page 1 of 4 2024-04-15 Letter to City Council -Item 27 Needle Distribution