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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Samuel R. Friedman, PhD1, Barbara Tempalski1, Don C. Des Jarlais, PhD2, Courtney McKnight3, Marie Keem1, and Maria Fernandez1. (1) Institute for AIDS Research, National Development and Research Institutes, 71 West 23d Street, New York, NY 10010, 212 845 4467, friedman@ndri.org, (2) Beth Israel Medical Center and National Development and Research Institutes, New York, New York, 71 West 23d Street, New York, NY 10010, (3) Chemical Dependency Institute, Beth Israel Medical Center, 215 Park Avenue South, New York, NY 10003
Background: Syringe exchange programs (SEPs) can help reduce HIV transmission among injection drug users (IDUs). Nonetheless, they are illegal and/or unwelcome in many communities. We explore what metropolitan area characteristics are related to having an SEP in the USA. Methods: Using data from a survey of SEPs, the US Census, and Holmberg (AJPH, 1996), we explored predictors of which metropolitan areas had SEPs. Potential predictors considered were (1) need (HIV prevalence and incidence among IDUs; proportion of population who are IDUs), (2) political facilitators and restraints (percent of metropolitan area population who are MSM; MSM HIV prevalence; and presence of laws against selling syringes without prescriptions [anti-OTC laws]), (3) diffusion (hundreds of miles from Tacoma, WA, the first above-ground US SEP) and (4) demographic and economic predictors (metropolitan area population; percent Black and Hispanic population; residential segregation isolation indices for Blacks and Hispanics; percent in poverty). Results: Indicators of need were not significant predictors of having an SEP. Predictors were percent of population who are MSM (AOR=22.9; 95% CI=3.13-168), metropolitan area population (AOR.=1.10; 95% CI=1.03-1.16), distance from Tacoma (AOR=0.92; 95% CI=0.85-0.99), and anti-OTC laws (AOR=0.40; 95% CI=0.13-1.20). Conclusions: Need is not associated with SEP presence, but diffusion is. Political factors seem to be related to SEP acceptance. Gay political influence and/or support may well facilitate SEP formation; and laws against OTC sales seem to make SEPs more difficult to set up and sustain.
Learning Objectives:
Keywords: Public Health Policy, Public Health Movements
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.