I 

111TH CONGRESS 

1ST SESSION H. R. 179 

To permit the use of Federal funds for syringe exchange programs for 

purposes of reducing the transmission of bloodborne pathogens, including 

HIV and viral hepatitis. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 6, 2009 

Mr. SERRANO (for himself, Mr. ABERCROMBIE, Mr. BERMAN, Mr. CAPUANO, 

Mrs. CHRISTENSEN, Mr. DELAHUNT, Mr. FARR, Mr. FATTAH, Mr. FILNER, Mr. GRIJALVA, Mr. HARE, Mr. HASTINGS of Florida, Mr. HINCHEY, 

Ms. NORTON, Mr. JACKSON of Illinois, Mr. KUCINICH, Ms. LEE of California, Mrs. MALONEY, Mr. MCDERMOTT, Mr. MORAN of Virginia, Mr. 

NADLER of New York, Mr. PAUL, Mr. RANGEL, Ms. ROS-LEHTINEN, Ms. 

ROYBAL-ALLARD, Ms. SCHAKOWSKY, Mr. TOWNS, Ms. WATERS, Mr. 

WAXMAN, and Ms. WOOLSEY) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To permit the use of Federal funds for syringe exchange 

programs for purposes of reducing the transmission of 

bloodborne pathogens, including HIV and viral hepatitis. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Community AIDS and 

5 Hepatitis Prevention Act’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds as follows: 

3 (1) Each year, approximately 12,000 Americans 

4 contract HIV/AIDS and approximately 19,000 

5 Americans contract the hepatitis C virus directly or 

6 indirectly from sharing contaminated syringes. 

7 (2) A 2005 comprehensive international review 

8 of the evidence of the effectiveness of syringe ex9 change programs in preventing HIV transmission 

10 shows that such programs reduce HIV transmission 

11 and are cost-effective. Eight additional federally 

12 funded research reports concluded that syringe ex13 change programs, as part of a comprehensive HIV 

14 prevention strategy, are an effective public health 

15 intervention that reduces HIV transmission without 

16 increasing the use of illicit drugs. Research has also 

17 shown that syringe exchange programs are impor18 tant in preventing the transmission of hepatitis B 

19 and C. In 2004, Dr. Elias A. Zerhouni, Director of 

20 the National Institutes of Health, wrote Members of 

21 Congress stating, ‘‘A number of studies conducted in 

22 the United States have shown that syringe exchange 

23 programs do not increase drug use among partici24 pants or surrounding community members and are 

25 associated with reductions in the incidence of HIV, 


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1 hepatitis B, and hepatitis C in the drug-using popu2 lation.’’. 

3 (3) As part of a comprehensive HIV and hepa4 titis C virus prevention effort, syringe exchange pro5 grams often provide HIV and hepatitis C counseling, 

6 testing, education, and tools to reduce sexual and 

7 drug use-related health risks; links to addiction 

8 treatment; overdose prevention; and referrals to 

9 other important medical and social services. Re10 search has shown that injection drug users who are 

11 referred to addiction treatment from syringe ex12 change programs are more likely to enter and re13 main in treatment. 

14 (4) Research has shown that, by providing safe 

15 disposal of used injection equipment, syringe ex16 change programs significantly reduce the number of 

17 improperly discarded syringes in the community, 

18 thereby reducing the exposure of police, sanitation 

19 workers, children, and others to dangers of blood20 borne disease from accidental syringe sticks. 

21 (5) Syringe exchange programs reduce the prev22 alence of HIV among injection drug users. A review 

23 of data from 81 cities across Europe, Asia, and 

24 North America found that, on average, HIV preva25 lence among injection drug users increased by 5.9 


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1 percent per year in the 52 cities without syringe ex2 change programs and decreased by 5.8 percent per 

3 year in the 29 cities with syringe exchange pro4 grams. 

5 (6) Syringe exchange programs are supported 

6 by American scientific and professional organiza7 tions, including the American Academy of Family 

8 Physicians, the American Academy of Pediatrics, the 

9 American Academy of Physicians Assistants, the 

10 American Academy of Addiction Psychiatry (for11 merly the American Academy of Psychiatrists in Al12 coholism and Addictions), the American Bar Asso13 ciation, the American Medical Association, the 

14 American Nurses Association, the American Phar15 macists Association, the American Psychiatric Asso16 ciation, the American Psychological Association, the 

17 American Public Health Association, the American 

18 Society of Addiction Medicine, the Association of 

19 Nurses in AIDS Care, the Association of State and 

20 Territorial Health Officials, the Infectious Diseases 

21 Society of America, the National Association of 

22 Boards of Pharmacy, the National Alliance of State 

23 and Territorial AIDS Directors, the United States 

24 Conference of Mayors, the World Health Organiza25 tion, UNICEF, the World Bank, the International 


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1 Red Cross-Red Crescent Society, UNAIDS, and the 

2 United Nations Office on Drugs and Crime; and 

3 United States government agencies, including the 

4 National Institutes of Health and the National Insti5 tute on Drug Abuse. 

6 (7) According to the most recent data from the 

7 Centers for Disease Control and Prevention, in 

8 2005, 185 syringes exchanges were operating in 36 

9 States, the District of Columbia, and Puerto Rico.

10 Removing barriers to the use of Federal funding will 

11 empower localities to use their funding in the most 

12 efficient way to prevent HIV and viral hepatitis. 

13 (8) Despite the scientific and public health con14 sensus that syringe exchange programs reduce HIV 

15 and do not increase substance abuse, a ban on fund16 ing syringe exchange has been enacted as part of 

17 each Departments of Labor, Health and Human 

18 Services, Education, and Related Agencies Appro19 priations Act since 1998. 

20 (9) A similar ban on the District of Columbia’s 

21 use of its own funds for needle exchange programs 

22 was lifted in fiscal year 2008. 

23 (10) Title XXVI of the Public Health Service 

24 Act, as added by the Ryan White Comprehensive 

25 AIDS Resources Emergency Act of 1990, is subject 


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1 to a statutory ban on funding needle exchange pro2 grams. 

3 SEC. 3. USE OF FEDERAL FUNDS PERMITTED FOR SYRINGE 

4 EXCHANGE PROGRAMS. 

5 Notwithstanding any other provision of law, nothing 

6 shall prohibit the use of Federal funds to establish or 

7 carry out a program of distributing sterile syringes to re8 duce the transmission of bloodborne pathogens, including 

9 the human immunodeficiency virus (HIV) and viral hepa10 titis. 

Æ 


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