Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #104706

Charles M. Cleland, PhD¹, Sherry Deren, PhD², Crystal Fuller, PhD³, Shannon Blaney, MPH³, James M. McMahon, PhD⁴, Stephanie Tortu, PhD⁵, Don C. Des Jarlais, PhD⁶, and David Vlahov, PhD⁷. (1) Center for Drug Use and HIV Research, National Development and Research Insitutes (NDRI), 71 West 23rd Street, 8th Floor, New York City, NY 10010, 212-845-4495, cleland@ndri.org, (2) National Development and Research Institutes, Inc., 71 West 23 Street, 8 Floor, New York, NY 10010, (3) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, (4) National Development and Research Institutes, 71 West 23rd Street, 8th Floor, New York, NY 10010, (5) School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2301, New Orleans, LA 70112, (6) National Development and Research Institutes; Beth Israel Med. Ctr, NYC, 71 West 23rd Street, 8th floor, New York, NY 10010, (7) Center for Urban Epidemiologic Studies (CUES), New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029

Background: The Expanded Syringe Access Demonstration Program (ESAP), permitting pharmacies to sell <10 syringes to individuals >18 years of age without prescription, was implemented in 2001 in New York State. A public health concern with this program is its possible impact on syringe disposal.

Objective: To examine temporal trends in syringe disposal practices since ESAP began, overall and by source of syringes.

Methods: Cross-sectional data were collected from January 2001 – September 2003 for 1030 IDUs recruited in New York City. Data were analyzed quarterly for very safe (e.g., clinic/doctor/hospital, sharps/disposal box, syringe exchange program (SEP), pharmacy) vs. fairly safe (e.g., garbage) vs. unsafe (i.e., ground/bushes, toilet, given away, left where shot up) disposal practices. The effect of syringe source (SEP, pharmacy, other) on very safe vs. less safe disposal was examined using logistic regression.

Results: Very safe disposal decreased over time since ESAP began (63–21%, Cochran-Armitage z = 7.48, p < .001); individuals who used SEPs or pharmacies as a syringe source were more likely to use very safe disposal practices (AORs = 20.97 and 2.91 vs. other, p < .001). Fairly safe disposal increased (18–64%, z = 7.22, p < .001) while unsafe disposal did not change (17% over time).

Conclusions: Very safe disposal practices appeared to decline, but this was due to a shift to fairly safe disposal – unsafe disposal did not change. A separate study showed no increase in discarded needles in these neighborhoods. Safer disposal of syringes obtained from safe, legal sources is encouraging.

Learning Objectives: At the conclusion of the session, the participant (learner) will be able to

• Articulate reasons for providing injection drug users greater access to new sterile syringes.
• List the specific ways in which the Expanded Syringe Access Demonstration Program (ESAP) allows greater access to syringes.
• Identify safe syringe disposal as a concern in evaluating ESAP’s impact on the community.
• Describe the effects of gender, age, syringe source, and other drug use variables on safe syringe disposal.
• Discuss factors which may lead injection drug users to dispose of syringes unsafely.
• Identify steps communities might take to reduce unsafe syringe disposal in the future.

Keywords: Injecting Drug Use, Pharmacies

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.