Pharmacy sales of over-the-counter syringes: Successes and challenges in syringe access and HIV prevention in California

Background: Since January 2005, in an effort to curb HIV transmission, California legislation (SB1159) permits individuals to legally purchase up to ten syringes over-the-counter (OTC) from registered pharmacies within local health jurisdictions (LHJs) that adopt the legislation.

Methods: From April-August 2006, we repeated a 2005 survey of health officials in all 61 LHJs to assess implementation status of SB1159. Questionnaires were emailed and non-responders were subsequently contacted by telephone and email. Variables of interest included: implementation status, facilitators and inhibitors to implementation, and program coverage.

Results: Fifty-five (90%) LHJs responded. Twelve LHJs (22%) authorized pharmacy sales by August 2006, up from 9 in 2005; 12 others (22%) planned to obtain authorization and 25 (46%) anticipated that their LHJ would never authorize SB1159. Two hundred sixty-three (28%) of 934 pharmacies located within the 12 LHJs that adopted SB1159 had registered to sell nonprescription syringes; an increase of 130 pharmacies from 2005 to 2006. Among 25 LHJs not planning to adopt SB1159, the principle reasons included: competing programmatic priorities (56%), challenges addressing syringe disposal (24%), little or no interest among pharmacies (24%), and strong law enforcement opposition (24%).

Conclusions: These results indicate that although there was a significant increase in the number of registered pharmacies in LHJs that approved SB1159, there was a small increase in the number of LHJs that authorized OTC syringe sales in 2006. Increased SB1159 education for health officials, pharmacists, law enforcement, and community stakeholders is needed to expand acceptance and implementation of OTC syringe sales in California.