Department of Medicine, University of California, San Francisco, CA, USA.
J Urban Health. 2010 Jul;87(4):534-42. doi: 10.1007/s11524-010-9468-y.
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.
注射器获取和处理选择的增加与高危行为的减少有关。本研究旨在确定注射吸毒者（IDU）获取注射器的药房比例，并评估药房获取与更安全的注射/处理做法之间的关联。在加利福尼亚州疾病预防示范项目实施两年后，该项目取消了通过获得当地授权的药房销售非处方注射器的限制，研究人员通过旧金山的街头外展招募 IDU，并对其最近的注射器获取、使用和处理情况进行了访谈。105 名参与者中，男性（67%）、有色人种（49%）和无家可归者（71%）的比例较高。最常见的注射器来源是注射器交换项目（SEP）（80%），有 39%的受访者会去药房获取注射器。最常见的处理来源是 SEP（65%），只有极少数人报告会将注射器丢弃在药房（2%）。调整分析表明，在药房购买注射器不成功会增加使用和丢弃使用过的注射器的几率。使用 SEP 会降低不安全的注射和处理做法的几率。因此，在加利福尼亚州疾病预防示范项目启动两年后，这项小型研究的结果表明，SEPs 仍然为旧金山 IDU 提供了大部分的注射器分发和处理服务；然而，现在药房也增加了注射器的可获得性。此外，不安全的注射行为在那些不使用这些注射器来源的人群中更为常见。这些结果与之前的研究一致，表明通过 SEP 和药房增加注射器的可获得性，并在两者之间建立桥梁，可能会进一步降低与注射器相关的风险。
