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. FIL-
NER, Mr. GRIJALVA, Mr. HARE, Mr. HASTINGS of Florida, Mr. HINCHEY, 
Ms. NORTON, Mr. JACKSON of Illinois, Mr. KUCINICH, Ms. LEE of Cali-
fornia, 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 re-
ferred 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Community AIDS and 
Hepatitis Prevention Act’’. 
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SEC. 2. FINDINGS. 
Congress finds as follows: 
(1) Each year, approximately 12,000 Americans 
contract HIV/AIDS and approximately 19,000 
Americans contract the hepatitis C virus directly or 
indirectly from sharing contaminated syringes. 
(2) A 2005 comprehensive international review 
of the evidence of the effectiveness of syringe ex-
change programs in preventing HIV transmission 
shows that such programs reduce HIV transmission 
and are cost-effective. Eight additional federally 
funded research reports concluded that syringe ex-
change programs, as part of a comprehensive HIV 
prevention strategy, are an effective public health 
intervention that reduces HIV transmission without 
increasing the use of illicit drugs. Research has also 
shown that syringe exchange programs are impor-
tant in preventing the transmission of hepatitis B 
and C. In 2004, Dr. Elias A. Zerhouni, Director of 
the National Institutes of Health, wrote Members of 
Congress stating, ‘‘A number of studies conducted in 
the United States have shown that syringe exchange 
programs do not increase drug use among partici-
pants or surrounding community members and are 
associated with reductions in the incidence of HIV, 
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hepatitis B, and hepatitis C in the drug-using popu-
lation.’’. 
(3) As part of a comprehensive HIV and hepa-
titis C virus prevention effort, syringe exchange pro-
grams often provide HIV and hepatitis C counseling, 
testing, education, and tools to reduce sexual and 
drug use-related health risks; links to addiction 
treatment; overdose prevention; and referrals to 
other important medical and social services. Re-
search has shown that injection drug users who are 
referred to addiction treatment from syringe ex-
change programs are more likely to enter and re-
main in treatment. 
(4) Research has shown that, by providing safe 
disposal of used injection equipment, syringe ex-
change programs significantly reduce the number of 
improperly discarded syringes in the community, 
thereby reducing the exposure of police, sanitation 
workers, children, and others to dangers of blood- 
borne disease from accidental syringe sticks. 
(5) Syringe exchange programs reduce the prev-
alence of HIV among injection drug users. A review 
of data from 81 cities across Europe, Asia, and 
North America found that, on average, HIV preva-
lence among injection drug users increased by 5.9 
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percent per year in the 52 cities without syringe ex-
change programs and decreased by 5.8 percent per 
year in the 29 cities with syringe exchange pro-
grams. 
(6) Syringe exchange programs are supported 
by American scientific and professional organiza-
tions, including the American Academy of Family 
Physicians, the American Academy of Pediatrics, the 
American Academy of Physicians Assistants, the 
American Academy of Addiction Psychiatry (for-
merly the American Academy of Psychiatrists in Al-
coholism and Addictions), the American Bar Asso-
ciation, the American Medical Association, the 
American Nurses Association, the American Phar-
macists Association, the American Psychiatric Asso-
ciation, the American Psychological Association, the 
American Public Health Association, the American 
Society of Addiction Medicine, the Association of 
Nurses in AIDS Care, the Association of State and 
Territorial Health Officials, the Infectious Diseases 
Society of America, the National Association of 
Boards of Pharmacy, the National Alliance of State 
and Territorial AIDS Directors, the United States 
Conference of Mayors, the World Health Organiza-
tion, UNICEF, the World Bank, the International 
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Red Cross-Red Crescent Society, UNAIDS, and the 
United Nations Office on Drugs and Crime; and 
United States government agencies, including the 
National Institutes of Health and the National Insti-
tute on Drug Abuse. 
(7) According to the most recent data from the 
Centers for Disease Control and Prevention, in 
2005, 185 syringes exchanges were operating in 36 
States, the District of Columbia, and Puerto Rico.
Removing barriers to the use of Federal funding will 
empower localities to use their funding in the most 
efficient way to prevent HIV and viral hepatitis. 
(8) Despite the scientific and public health con-
sensus that syringe exchange programs reduce HIV 
and do not increase substance abuse, a ban on fund-
ing syringe exchange has been enacted as part of 
each Departments of Labor, Health and Human 
Services, Education, and Related Agencies Appro-
priations Act since 1998. 
(9) A similar ban on the District of Columbia’s 
use of its own funds for needle exchange programs 
was lifted in fiscal year 2008. 
(10) Title XXVI of the Public Health Service 
Act, as added by the Ryan White Comprehensive 
AIDS Resources Emergency Act of 1990, is subject 
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