To examine injection drug users (IDUs) opinions and behavior regarding purchase of sterile syringes from pharmacies.
Urban and rural sites in Colorado, Connecticut, Kentucky, and Missouri.
Eight focus groups, with 4 to 15 IDU participants per group.
Transcripts of focus group discussions were evaluated for common themes by the authors and through the use of the software program NUD*IST.
Knowledge of human immunodeficiency virus (HIV), pharmacy use, barriers to access from pharmacies, high-risk and risk-reducing behavior, and rural/urban difference.
Almost all participants knew the importance of using sterile syringes for disease prevention and reported buying syringes from pharmacies more than from any other source. Two IDUs believed pharmacists knew the syringes were being used for injecting drugs and perceived pharmacists' sales of syringes to be an attempt to contribute to HIV prevention. Most IDUs reported that sterile syringes were relativity easy to buy from pharmacies, but most also reported barriers to access, such as having to buy in packs of 50 or 100, being made to sign a book, having to make up a story about being diabetic, or having the feeling that the pharmacists were demeaning them. While the majority of IDUs reported properly cleaning or not sharing syringes and safely disposing of them, others reported inadequate cleaning of syringes and instances of sharing syringes or of improper disposal. There were few differences in IDUs' reported ability to buy syringes among states or between urban and rural sites, although the data suggest that IDUs could buy syringes more easily in the urban settings.
For the most part, participants understood the need for sterile syringes in order to protect themselves from HIV, hepatitis B virus, and hepatitis C virus and saw pharmacies as the best source of sterile syringes. Although these data are not generalizable, they suggest that pharmacists can and do serve as HIV-prevention service providers in their communities.
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"Studies regarding the impact of syringe acquisition through pharmacy sales are few. Those conducted suggest the value of pharmacies in HIV prevention, as evidenced by lower rates of HIV risk behaviors among IDUs who successfully use pharmacies to purchase syringes,10–12 the significant contributions of pharmacists as HIV prevention service providers,13 and the importance of community-level education regarding pharmacies as syringe resources.14 Many state and local municipalities throughout the USA have therefore amended laws by permitting the sale of non-prescription syringes. "
[Show abstract][Hide abstract] ABSTRACT: Increased options for syringe acquisition and disposal have been associated with reductions in high-risk behaviors. This study determined the extent of pharmacy uptake in accessing syringes among injection drug users (IDUs) and estimated associations between pharmacy uptake and safer injection/disposal practices. Two years after the implementation of California's Disease Prevention Demonstration Project, which removed restrictions to non-prescription syringe sales through pharmacies with local authorization, IDUs were recruited through street outreach in San Francisco and interviewed regarding recent syringe acquisition, use, and disposal. The sample of 105 persons included a high proportion of men (67%), people of color (49%), and homeless persons (71%). The most common syringe source was a syringe exchange program (SEP) (80%), with pharmacies being accessed by 39% of respondents. The most commonly cited source of disposal was a SEP (65%), with very few reports of pharmacy disposal (2%). Adjusted analysis showed that unsuccessful attempts to purchase syringes at a pharmacy increased the odds of both injecting with a used syringe and giving away a used syringe. Using a SEP decreased the odds of unsafe injection and disposal practices. Thus, 2 years after the initiation of the California Disease Prevention Demonstration Project, results from this small study suggest that SEPs still provide the majority of syringe distribution and disposal services to San Francisco IDUs; however, pharmacies now augment syringe access. In addition, unsafe injection behavior is reported more often among those who do not use these syringe sources. These results are consistent with prior studies in suggesting that increasing the availability of syringes through SEPs and pharmacies, and developing bridges between them, may further reduce syringe-related risk.
Journal of Urban Health 07/2010; 87(4):534-42. DOI:10.1007/s11524-010-9468-y · 1.90 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective: To compare demographic and injecting characteristics of clients collecting needle syringes from needle syringe programmes (NSPs) and pharmacies. Methods: Clients obtaining needle syringes from three NSPs and one pharmacy in the same geographic area during one and four weeks, respectively were asked to complete a self-administered questionnaire. Results: Approximately half the 336 NSP (56%) and 63 pharmacy (49%) respondents reported using both NSPs and pharmacies in the past month. NSP and pharmacy respondents were similar on many characteristics: male gender (60 and 62%, respectively); median age (30 years for both groups); median age at first injection (18 years both groups); history of methadone treatment (62 and 53%); and heroin as the last drug injected (60 and 59%). NSP respondents were more likely than pharmacy respondents to report imprisonment in the previous year (20% versus 8%, P = 0.05), daily injection (67% versus 56%, P = 0.09) and re-use of more than one other person's needle syringe in the previous month (27% versus 7% of 52 and 15 reporting needle syringe re-use). Pharmacy respondents were more likely than NSP respondents to report amphetamine use (32% versus 10%, P < 0.001), shared use of tourniquets (24% versus 12%, P=0.01), spoons (43% versus 32%, P=0.09), filters (22% versus 15%, P = 0.1), or drug mix (16% versus 9%, P=0.1), and difficulty finding a vein (73% versus 26%, P < 0.001). Conclusion: The risk profile of IDUs (Injecting Drug Users) recruited at various sites provides important information for behavioural surveillance and health promotion efforts. Increased convenience of needle syringe access enhances HIV prevention efforts, however, appropriate education is required for people obtaining needle syringes at pharmacies to reduce sharing of injecting equipment other than needle syringes. copyright 2003 Elsevier B.V. All rights reserved.
International Journal of Drug Policy 12/2003; 14(5-6-5-6):425-430. DOI:10.1016/j.drugpo.2003.06.001 · 2.40 Impact Factor