5098.0: Wednesday, November 15, 2000 - 1:35 PM

Abstract #12577

Homeless IDUs Enrolled in a Pilot Harm Reduction Intervention: Physician Syringe Prescription

S. Michelle McKenzie, MPH, Megan E. Gaydos, Meena Mehrota, Tom Whitlock, Val Runnarsdottir, MD, Grace Macalino, PhD, Christopher Salas, and Josiah D. Rich, MD, MPH. Division of Immunology, The Miriam Hospital/Brown University, 164 Summit Avenue, 3rd Floor Fain Building, Providence, RI 02906, 401/793-4790, mmckenzie@lifespan.org

Background: Limiting access to clean syringes has driven the HIV epidemic by increasing the reuse and sharing of syringes among injection drug users (IDUs). To increase access to sterile syringes we initiated an intervention of syringe prescription by physicians. Its goals are to reduce syringe sharing, provide access to primary health care services, and increase access to substance abuse treatment and IDU-relevant services. This presentation focuses on the homeless project participants. Methods: Recruitment occurs through outreach to community settings, including homeless service agencies, and participant referrals. Each participant receives free medical care, including HIV, hepatitis and TB screening, and, if necessary, a prescription for sterile syringes. Follow-up medical appointments and referrals are scheduled as needed. Results: To date, we have enrolled 56 homeless participants (54% of 103 total enrolled); 71% are male; 63% white; 25% black; and average age is 39. Heroin is reported as the drug of choice (91%). Forty-three percent of participants report ever having used a needle exchange, 13% use the exchange on a regular basis. Preliminary 3-month follow-up data for 13 participants shows a decrease in injecting with used syringes (69% to 23%); a decrease in number of injections per day (4.8 to 2.5); and an increase in current enrollment in substance abuse treatment (8% to 54%). Conclusions: Thus far syringe prescription has proven to be a feasible strategy in outreaching to IDUs, particularly homeless injectors. Further research is needed to assess participation over time and follow-up of drug treatment and other services referrals.

Learning Objectives: 1) Describe the essential components of physician syringe prescription. 2) Identify the characteristics of homeless IDUs in the sample and describe their risk behaviors in relationship to housed participants. 3) Discuss the success of the intervention in terms of feasibility and increasing access to sterile syringes

Keywords: Homeless, Injection Drug Users

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
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.

The 128th Annual Meeting of APHA