185622 Syringe deregulation: Are pharmacies reaching high-risk injectors?

Tuesday, October 28, 2008

Katherine Standish, BA , Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY
Shannon Blaney, MPH , Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY
Natalie Crawford, MPH , Department of Epidemiology, Columbia University, New York City, NY
Crystal M. Fuller, PhD , Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY
Background: In 2001 New York State deregulated syringe sales at pharmacies with the explicit aim of curbing transmission of HIV and other infectious diseases among injection drug users (IDUs). Such policy assumes pharmacy sales will increase syringe availability to high-risk populations not previously accessing sterile syringes. The purpose of this study is to determine if pharmacy syringe availability is reaching IDUs without prior access to sterile syringe sources. Methods: We analyzed data from cross-sectional surveys of IDUs recruited through random street intercept and from syringe-furnishing pharmacies in New York City. We compared IDUs who had ever purchased syringes at a pharmacy to those who had not with respect to injection risk behaviors and syringe acquisition prior to first pharmacy syringe purchase. Results: Of 142 participants, 48.6% had purchased syringes from a pharmacy, 33.1% were female, 59.2% were Hispanic, 25.4% were black, the median age was 37, and 40.2% reported daily injection. After adjustment, black IDUs (OR=0.1, 95%CI=0.0-0.5), and those reporting syringe exchange as the most frequent source prior to first pharmacy use (OR=0.3, 95%CI=0.1-0.6) were significantly less likely to use pharmacies as a syringe source. Conclusion: Expanded syringe access through pharmacies is reaching populations that didn't previously have access to safe syringe sources, namely syringe exchange programs. However, blacks are less likely to adopt pharmacies as syringe sources, a troubling trend considering the high rates of infection in communities of color. Interventions should focus on making pharmacies more attractive and comfortable venues for black IDUs.

Learning Objectives:
Learning Objectives: 1. Describe safe and unsafe syringe sources in New York City. 2. Recognize barriers to safe syringe sources and populations with limited access. 3. Discuss interventions to increase utilization of safe syringe sources.

Keywords: Syringe Sources, HIV Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: 4 years working in public health research and 2.5 years running the study being presented.
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.