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June 15, 1994

Syringe and Needle Exchange to Prevent HIV Infection-Reply

Author Affiliations

Beth Israel Medical Center Boston, Mass
National Development and Research Institutes, Inc New York, NY

JAMA. 1994;271(23):1826. doi:10.1001/jama.1994.03510470029019

In Reply.  —Dr Fernando raises both methodologic and policy issues. We reported that increased use of syringe exchange was accompanied by decreases in injecting with used syringes and in passing used syringes on to others. Dr Fernando states that we should have considered "rented" as well as "used, lent, and exchanged" syringes. In this analysis, injections with rented, used syringes were a subset of injection with used syringes. The frequency of injections with rented, used syringes was too low to analyze for 1990 through 1992 (see "shooting gallery injections" in Table 3). Our previous reports have addressed expansion of the street market in injection equipment in response to IDUs' concerns about AIDS.1We agree that no single sample could be representative of the New York City IDU population. Our sample, however, is one of the most representative available, for reasons detailed in the article, including the citywide scope of

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