AARON PEAK
Needle Exchange & the Rubber Room
Every once in a while, a single person has a profound impact on the trajectory of an epidemic, even though they are only faintly remembered by those who survived. One such person is Aaron Peak, who introduced needle exchange to Hawaiʻi during the height of the HIV/AIDS crisis.
Peak came to Hawaiʻi from San Diego in the mid-1980s. He was HIV+, and his partner had died of AIDS. Hoping to prevent others from contracting the disease, he joined the Hawaiʻi AIDS Task Group, an island-wide organization of health workers, activists, law enforcement, legislators, and community leaders chaired by University of Hawaiʻi professor Milton Diamond.
Hoping to slow the spread of HIV among sex workers and intravenous drug users, Peak began the “rubber room” at 61 N Hotel Street in Chinatown, a place where people could come for a while, relax, and get information and referals. They could also get free condoms, which Peak obtained from the Hawaiʻi State Health Department, and bleach to sterilize their syringes. Initially Peak paid the $250 rent out of his own pocket, but soon he obtained funding from the Life Foundation, which had been founded in 1983 as one of the first AIDS service organizations in the country.
In 1989, Peak attended the World AIDS Conference in Montreal, where he learned about the work of David Purchase, another HIV+ advocate who was responsible for starting the first legal needle exchange program in the United States in Tacoma, Washington. Hoping to replicate his success in Hawaiʻi, Peak invited Purchase to visit the islands, and suggested that he bring some syringes with him. Soon after, Peak began a quiet needle exchange program at the rubber room which local police, understanding the circumstances, unofficially allowed to take place.
“Peak was around 6 feet tall, 220 pounds, with reddish hair and a creamy complexion; he had a gold tooth; he had a heart for people; he was just a ball of light; he was just very, very real, very compassionate, very loving; he was fascinating, bright eyes, a great smile, and had very unusual, long, tubed shaped earrings, an incredibly warm spirit.”
- Dave Purchase
The Honolulu City Prosecutor, Keith Kaneshiro, was less sympathetic. When he learned what was happening at the Rubber Room, he threatened to have Peak arrested for violating the state paraphernalia law. When Dave Purchase asked him what he was going to do, Peak’s response was “I’m going to quit being an activist and become a lobbyist.”
Peak’s first move was to organize the Hawaiʻi Sterile Needle Exchange Coalition, a group of concerned public health, medical, substance abuse, and HIV service professionals headed by Dr. John Lewin, the Director of the Hawaiʻi Health Department. At their first meeting on September 18, 1989, it was decided to propose to the legislature a bill that would change the paraphernalia law, decriminalizing the possession of syringes. Not surprisingly, this idea was staunchly opposed by law enforcement, and the bill never moved out of committee.
Undeterred, Peak and members of the coalition set out on an extensive education, public relations, and lobbying campaign. It was decided that instead of legalizing drug paraphernalia, it would be more strategic to seek a law giving the Director of Health the power to establish a trial needle exchange program that would be continued only if successful. The program would include counselling, testing, and referrals, and would be completely funded by private sources. Publicity efforts focused on the potential beneficial effects on public safety and reducing the number of infants born with HIV. Meanwhile the coalition broadened its outreach to include various civic groups, community leaders, and religious organizations.
This coordinated effort paid off. On June 25, 1990, Governor John David Waiheʻe III signed into law a bill authorizing the first state-approved needle exchange program in the United States. Peak, who had been hired as a full-time outreach worker by the Life Foundation, could now run his sterile needle exchange program at the Rubber Room with the full knowledge and approval of the Honolulu Police Department. Over the next year, the program was expanded by the addition of outreach workers from the Department of Health and from CHOW (Community Health Outreach Work), a contracted program set-up through the University off Hawaiʻi. In 1992, anticipating the end of the pilot program, the Hawaiʻi Sterile Needle Exchange Coalition returned to the legislature and successfully introduced bills to establish an ongoing needle exchange program with state funding.
Peak attended the Asian International AIDS Conference in New Delhi in 1992, where he came to the realization that he was more interested in starting new programs than in running an established one. Soon after, he left Hawaiʻi for India and then Nepal and Thailand, where he helped establish some of the first needle exchange programs in Asia.
Although Peak was in Hawaiʻi but briefly, his impact has been long-lasting. Between 1992 and 2023, nearly 18 million syringes have been exchanged statewide by the program, which is now run by the successor of the Life Foundation, the Hawaiʻi Health and Harm Reduction Center. Yearly evaluations have demonstrated that the program is effective in preventing HIV and other blood-borne diseases like hepatitis and has also been cost-effective for the state.
The story of Aaron Peak shows how a single person can alter the course of an epidemic, especially when they are working in an environment that values science, public health, common sense, and compassion.
Story by Dean Hamer for Lei Pua ʻAla Queer Histories of Hawai’i.
Mahalo nui loa to Penny L. Morrison for her guidance and providing copies of her thesis and of Aaron Peak’s unpublished manuscript. Thank you also for the input from Dr. David McEwan and the Hawaiʻi Health and Harm Reduction Center and community members who are helping with the collecting of HIV/AIDS stories in Hawaiʻi.
References:
Penny L. Morrison. “A Positive Perfect Storm: Creation and Development of Hawaiʻi’s Syringe Exchange Program - Harm Reduction in Action?” Dissertation at the University of Hawaiʻi at Manoa School of Nursing, 2017. https://scholarspace.manoa.hawaii.edu/server/api/core/bitstreams/b4d9c3b8-adfd-4818-8eda-d52e1006a3c7/content
Dave Purchase. “The First Time I Didnʻt Meet Aaron Peak.” Harm Reducion International, 2012. https://www.hri.global/files/2012/09/12/Aaron_Peak_DP_reflections.doc
Aaron Peak. A History of a Community Based Effort to Establish Legal Needle Exchange in the State of Hawaiʻi. Unpublished manuscript, 1990.
