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June 15, 1994

Syringe and Needle Exchange to Prevent HIV Infection-Reply

Author Affiliations

University of California—San Francisco
Prevention Point Research Group San Francisco, Calif
Columbia University New York, NY

JAMA. 1994;271(23):1826-1827. doi:10.1001/jama.1994.03510470029020

In Reply.  —In our article in JAMA we concluded that needle sharing (a term Dr Fernando dislikes) is perpetuated by laws that restrict access to and possession of needles and syringes. We disagree with Fernando's assertion that NEPs undermine progress toward the needed deregulation of injection equipment. Needle-exchange programs have led directly to the relaxation and/or repeal of antiparaphernalia laws in Connecticut, Hawaii, Maryland, Massachusetts, and throughout Australia. Consequently, we think the successful demonstration of syringe exchange will continue to help, not impede, modification of these laws. We likewise question the veracity of Fernando's claim that outreach efforts involving bleach distribution for needle disinfection have already interfered with such progress.Needle exchange, like all health promotion technologies, has limitations and we addressed some of these in our article. Despite these limitations, in our study NEP use was a robust predictor of not sharing needles, and this effect increased with the

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