Effects of pharmacy syringe access on syringe sharing among young heroin injectors

Background: Expanding access to sterile syringes is an important strategy for reducing the transmission of HIV and hepatitis among injection drug users. In 2003, Illinois law was amended to allow the purchase of up to 20 syringes without a prescription. At the same time, paraphernalia laws were also changed to decriminalize the possession of a limited number of syringes. We conducted a secondary analysis of data collected both before and after these changes were enacted to examine changes in syringe sharing. Methods: Data were collected in a study of transitions to injecting among young non-injecting heroin users in Chicago. Participants completed a computer-assisted interview at baseline, and at approximately 6-month intervals for up to 36 months. Using GEE regression, we tested the effect of the enactment of the pharmacy access law on injecting with a syringe that was previously used by someone else. Results: Syringe sharing decreased by about two-thirds following enactment of the pharmacy access law (OR = 0.33, 95% CI 0.11-0.99), from 61% to 35% of individuals. The effect was more pronounced among Whites (OR = 0.13, 95% CI 0.03-0.63; decreasing from 76% to 30%), but was absent among non-Whites. Non-White injectors had a lower rate of receptive sharing, however, prior to pharmacy access (37%). Although not statistically significant, homeless individuals also appeared not to benefit from pharmacy access. Conclusions: Access to sterile syringes through pharmacy sales has had a positive effect on injection risk behavior among young people who inject drugs in the Chicago area.