Impact of expanding syringe access in New York on sources of syringes for injection drug users in Harlem and the Bronx, NYC, USA

Deren, Sherry; Fuller, Crystal; Pouget, Enrique R; Blaney, Shannon; Tortu, Stephanie; Kang, Sung-Yeon; McMahon, James M; Andia, Jonny F; Des Jarlais, Don C; Johnson, Bruce; Rosenblum, Andrew; Vlahov, David

doi:10.1016/S0955-3959(03)00137-3

« Previous Next »International Journal of Drug Policy
Volume 14, Issue 5 , Pages 373-379, December 2003

Impact of expanding syringe access in New York on sources of syringes for injection drug users in Harlem and the Bronx, NYC, USA

Sherry Deren
- Institute for AIDS Research, Center for Drug Use and HIV Research, National Development & Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, USA
- Corresponding author. Tel.: +1-212-845-4463; fax: +1-917-438-0894.
Crystal Fuller
- Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, USA
- Tel.: +1-212-822-7391; fax: +1-212-876-6220.
Enrique R Pouget
- Institute for AIDS Research, Center for Drug Use and HIV Research, National Development & Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, USA
- Tel.: +1-212-845-4488; fax: +1-917-438-0894.
Shannon Blaney
- Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, USA
- Tel.: +1-212-419-3541; fax: +1-212-876-6220.
Stephanie Tortu
- Department of Community Health Sciences, Tulane University School of Public Health and Tropical Medicine, 1140 Canal Street, Suite 2301, New Orleans, LA 70112, USA
- Tel.: +1-504-988-4535; fax: +1-504-584-3540.
Sung-Yeon Kang
- Institute for AIDS Research, Center for Drug Use and HIV Research, National Development & Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, USA
- Tel.: +1-212-845-4457; fax: +1-917-438-0894.
James M McMahon
- Institute for AIDS Research, Center for Drug Use and HIV Research, National Development & Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, USA
- Tel.: +1-212-845-4553; fax: +1-917-438-0894.
Jonny F Andia
- Institute for AIDS Research, Center for Drug Use and HIV Research, National Development & Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, USA
- Tel.: +1-212-845-4580; fax: +1-917-438-0894.
Don C Des Jarlais
- Institute for AIDS Research, Center for Drug Use and HIV Research, National Development & Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, USA
- The Edmond de Rothschild Foundation, Chemical Dependency Institute, Beth Israel Medical Center, 1st Avenue and 16th Street, New York, NY 10003, USA
- Tel.: +1-212-387-3803/845-4463; fax: +1-212-387-3897/917-438-0894.
Bruce Johnson
- Institute for Special Populations Research, National Development & Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, USA
- Tel.: +1-212-845-4500; fax: +1-917-438-0894.
Andrew Rosenblum
- Institute for Treatment and Services Research, National Development & Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, USA
- Tel.: +1-212-845-4528; fax: +1-917-438-0894.
David Vlahov
- Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, USA
- Tel.: +1-212-822-7391; fax: +1-212-876-6220.

Received 1 December 2002; received in revised form 15 March 2003; accepted 18 June 2003.

Abstract

Beginning in January 2001, it became legal for pharmacies, health care facilities and certain health care providers in New York State (NYS) to sell or provide syringes (10 maximum) without prescription. Cross-sectional survey data from three research projects recruiting active injection drug users (IDUs) in Harlem and the South Bronx (n=682) were analysed by calendar quarter, from January 2001 through September 2002, to assist in an evaluation of the impact of the program, the Expanded Syringe Access Demonstration Program (ESAP). The outcome variable examined was having used a pharmacy as the source of the last injection syringe. The percent of IDUs who knew that it was legal to buy a syringe from a pharmacy increased over time (25–54%, P<0.001). Pharmacy as the source of the last injection syringe increased to approximately 20%, and syringe exchange programmes (SEPs) remained the most common source (approximately 50%). In a multiple logistic regression analysis, IDUs who knew it was legal were more likely to have purchased their last syringe from a pharmacy (AOR=4.65, CI=2.58–8.36). Pharmacies were more likely to be used by those who were younger (AOR=0.96, CI=0.93–0.99) and those who were White (AOR=2.55, CI=1.30–5.00), and calendar quarter was a significant independent predictor of pharmacy use (AOR=1.22, CI=1.06–1.40). Overall, these data indicate that: (a) knowledge about the option of purchasing syringes from a pharmacy has increased, but enhanced dissemination efforts to IDUs, especially particular sub-groups, are needed; and (b) pharmacies were becoming a supplemental source of syringes for active IDUs (in communities served by SEPs).

Keywords: Injection drug use, Pharmacy, Syringe access, AIDS, HIV, Substance use