We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

The Incidence of HBV Infection and Syringe Exchange Programs

Holly Hagan, MPH; Terry Reid, MSW; Don C. Des Jarlais, PhD; David Purchase; Samuel R. Friedman, PhD; Thomas A. Bell, MD, MPH
JAMA. 1991;266(12):1646-1647. doi:10.1001/jama.1991.03470120048019.
Text Size: A A A
Published online


To the Editor.  —The incidence of hepatitis B virus (HBV) infection has been proposed as a marker for syringe sharing and human immunodeficiency virus transmission among injecting drug users. Pierce County, Washington, which includes Tacoma, is one of four sentinel counties in a national hepatitis surveillance system. The sentinel surveillance system is characterized by reliable reporting of HBV incidence and standardized determination of risk behaviors for HBV.1 Tacoma is also the location of the first syringe exchange program in North America; its operations are described elsewhere.2 Currently, an estimated 500 drug injectors exchange 2000 syringes each week in five Pierce County exchange locations. There are approximately 3000 drug injectors in the county; the syringe exchange program provides a means for safer injection for a substantial proportion of drug users. Syringe exchange users report a mean of three to four injections per day and are probably among the most


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.