Syringe deregulation: Are pharmacies reaching high-risk injectors?

Background: In 2001 New York State deregulated syringe sales at pharmacies with the explicit aim of curbing transmission of HIV and other infectious diseases among injection drug users (IDUs). Such policy assumes pharmacy sales will increase syringe availability to high-risk populations not previously accessing sterile syringes. The purpose of this study is to determine if pharmacy syringe availability is reaching IDUs without prior access to sterile syringe sources. Methods: We analyzed data from cross-sectional surveys of IDUs recruited through random street intercept and from syringe-furnishing pharmacies in New York City. We compared IDUs who had ever purchased syringes at a pharmacy to those who had not with respect to injection risk behaviors and syringe acquisition prior to first pharmacy syringe purchase. Results: Of 142 participants, 48.6% had purchased syringes from a pharmacy, 33.1% were female, 59.2% were Hispanic, 25.4% were black, the median age was 37, and 40.2% reported daily injection. After adjustment, black IDUs (OR=0.1, 95%CI=0.0-0.5), and those reporting syringe exchange as the most frequent source prior to first pharmacy use (OR=0.3, 95%CI=0.1-0.6) were significantly less likely to use pharmacies as a syringe source. Conclusion: Expanded syringe access through pharmacies is reaching populations that didn't previously have access to safe syringe sources, namely syringe exchange programs. However, blacks are less likely to adopt pharmacies as syringe sources, a troubling trend considering the high rates of infection in communities of color. Interventions should focus on making pharmacies more attractive and comfortable venues for black IDUs.