Objective: To determine the extent that closing one pharmacy-based needle exchange program(NEP) site is associated with attrition, and characterize clients returning to alternate sites. Methods: From 12/97-9/98, two pharmacy-based NEP sites and one van-based site operated in West Baltimore. In 9/98, one pharmacy site closed due to logistical difficulties. Chi-square tests were used to compare characteristics among clients returning to any alternate NEP site vs. those who did not, and to compare clients returning to equidistant pharmacy or van-based NEP site during the post-closure period (9/98-8/99). Analysis was restricted to participants with at least one visit following enrollment. Results: During the post-closure period, of 211 clients enrolled at the pharmacy site that closed, 113(54%) never returned to another NEP site; attrition at the other pharmacy-based and van site was lower 48%(non-significant, p=0.5). Relative to clients returning after the pharmacy site closed, increased proportions of those who didnít return were <20 years old at initiation of injection(58%vs.43%, p=0.03) and were younger when they began injecting regularly (p=0.03); a lower proportion used speedballs in the prior six months(78%vs.92%, p<0.01). Among clients who returned post-closure, the majority(81%) accessed a pharmacy-based site rather than the equidistant van-based site(10%). Conclusions: Although closing a pharmacy-based site didnít lead to significantly higher attrition, longer-term drug users were less likely to return to an alternative NEP site. Among participants returning, most chose an alternative pharmacy-based NEP rather than a van-based site. These data suggest preferential NEP venue use by clients, which is an important consideration for program planning.
Learning Objectives: 1) Identify the concerns related to closing a NEP site in terms of participant attrition and redirection to other needle exchange sites. 2) Identify preferrential return by needle exchange program (NEP) participants to particular NEP venues
Keywords: Needle Exchange, HIV/AIDS
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