181447 Syringe sources utilized by IDUs in California pre- and post- implementation of a pharmacy-based syringe sales initiative

Tuesday, October 28, 2008: 3:06 PM

Thomas J. Stopka, MHS , Epidemiologic Studies Section, California Department of Public Health, Office of AIDS, Sacramento, CA
Atsuko Nonoyama, PhD , Epidemiologic Studies Section, California Department of Public Health, Office of AIDS, Sacramento, CA
Janie F. Shelton, MPH , Epidemiologic Studies Section, CDPH Office of AIDS, Sacramento, CA
Juan Ruiz, MD, DrPH , Epidemiology Branch, California Department of Public Health, Office of AIDS, Sacramento, CA
Richard S. Garfein, PhD, MPH , Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
Elise D. Riley, PhD , Department of Medicine, University of California, San Francisco, San Francisco, CA
Ricky N. Bluthenthal, PhD , Department of Preventive Medicine Institute for Prevention Research Keck School of Medicine, University of Southern California, Alhambra, CA
BACKGROUND: Expanded syringe access has lead to decreases in injection-mediated HIV risk behaviors among injection drug users (IDUs) internationally. In 2005, California became the 46th U.S. State to permit over-the-counter (OTC) syringe sales in an effort to prevent HIV transmission. We assessed changes in self-reported syringe sources among IDUs pre- and post-implementation of the pharmacy-based syringe sale program.

METHODS: Analyses were conducted on 2004-06 data from HIV Counseling and Testing (C&T) sessions in California Counties that implemented OTC syringe sales programs early (Contra Costa, Alameda, Sonoma, San Francisco, Los Angeles). Data from 17,579 testing sessions where clients reported injection drug use in the previous two years were analyzed.

RESULTS: HIV positive test results by county ranged from 0.4-6.0%. Reported use of pharmacies for syringe acquisition increased in all counties from 2004-06; Sonoma (2.9% vs. 28.8%), Los Angeles (6.5% vs. 21.3%), Contra Costa (1.5% vs. 16.2%), San Francisco (1.9% vs. 13.5%), and Alameda (1.5% vs. 5.3%). In some counties, IDUs reported obtaining syringes from pharmacies prior to implementation of OTC syringe sales programs. Secondary syringe exchange as a source of syringes decreased from 2004-06 in San Francisco (9.4% vs. 3.9%) and Sonoma (9.4% vs. 1.3%); however, an increase was observed in Alameda (7.8% vs. 16.6%).

CONCLUSIONS: Findings indicate IDUs attending State-funded C&T services are increasingly using pharmacies as a source of sterile syringes in California while changes in acquisition patterns for other syringe sources have been less predictable. Further research on the impact of this access on HIV risk is needed.

Learning Objectives:
1. Describe IDU utilization of pharmacies as a source of sterile syringes pre- and post implementation of CA Senate Bill 1159. 2. Describe changes in other syringe sources used by IDUs in CA since pharmacy syringe sales programs began. 3. Discuss data-driven strategies for enhanced HIV prevention through improved syringe access programs.

Keywords: Injecting Drug Use, Public Health Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceptualized the study design, contributed to data analyses and interpretations, and wrote the orginal abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.