Urban Community Research Center, Sociology Department, California State University Dominguez Hills, 1000 East Victoria Street, Carson, CA 90747, USA.
J Urban Health. 2010 Jul;87(4):543-52. doi: 10.1007/s11524-010-9483-z.
Increasing sterile syringe access for injection drug users (IDUs) is one way to prevent HIV and hepatitis C virus (HCV) transmission in this population. In 2005, California Senate Bill 1159 allowed counties to adopt the Disease Prevention Demonstration Project (DPDP). Where enacted, the DPDP allows pharmacies that register with the county to sell up to ten syringes to adults without a prescription. In the current study, we describe pharmacy participation in nonprescription syringe sales (NPSS) in two counties in California and examine factors associated with NPSS. Telephone and in-person interviews were conducted in Los Angeles (LA) and San Francisco (SF) with 238 pharmacies in 2007 (n = 67 in SF; n = 171 in LA). Quantitative survey items captured pharmacy registration with the county, pharmacy policies/practices, episodes and conditions of NPSS and refusals to sell, potential negative consequences of NPSS, and staff attitudes regarding HIV and HCV prevention for IDUs. Overall, 42% of pharmacies reported NPSS (28% in LA and 81% in SF), although only 34% had registered with the county (17% in LA and 76% in SF). Many pharmacies required proof of a medical condition (80% in LA and 30% in SF) and refused NPSS if the customer was a suspected IDU (74% in LA, 33% in SF). Few negative consequences of NPSS were reported. In multivariate logistic regression analysis, we found that the odds of NPSS were significantly higher among pharmacists who thought syringe access was important for preventing HIV among IDUs [adjusted odds ratio (AOR) = 2.95; 95% confidence interval (CI) = 1.10-7.92], were chain pharmacies (AOR = 12.5; 95% CI = 4.55-33.33), and were located in SF (AOR = 4.88; 95% CI = 1.94-12.28). These results suggest that NPSS were influenced by pharmacists' perception. NPSS might be increased through greater educational efforts directed at pharmacists, particularly those in non-chain pharmacies.
增加无菌注射器的获取途径，为注射吸毒者（IDU）提供便利，是预防该人群中 HIV 和丙型肝炎病毒（HCV）传播的一种方法。2005 年，加州参议院第 1159 号法案允许各县通过疾病预防示范项目（DPDP）实施。在已颁布该法案的地区，药剂师只要在该县登记，就可以在没有处方的情况下向成年人出售多达十支注射器。在当前的研究中，我们描述了加利福尼亚州两个县的非处方注射器销售（NPSS）的药房参与情况，并探讨了与 NPSS 相关的因素。2007 年，我们在洛杉矶（LA）和旧金山（SF）对 238 家药店进行了电话和现场访谈（SF 有 67 家，LA 有 171 家）。定量调查项目收集了与该县注册、药房政策/实践、NPSS 发作和拒绝销售、NPSS 的潜在负面影响、以及工作人员对 IDU 艾滋病毒和 HCV 预防的态度有关的信息。总体而言，42%的药店报告有 NPSS（LA 为 28%，SF 为 81%），尽管只有 34%的药店在该县注册（LA 为 17%，SF 为 76%）。许多药店要求提供医疗条件证明（LA 为 80%，SF 为 30%），如果顾客被怀疑是 IDU，则拒绝 NPSS（LA 为 74%，SF 为 33%）。很少有 NPSS 的负面后果被报道。在多变量逻辑回归分析中，我们发现，认为注射器获取对 IDU 预防 HIV 很重要的药剂师（调整后的优势比（AOR）=2.95；95%置信区间（CI）=1.10-7.92）、连锁药店（AOR=12.5；95%CI=4.55-33.33）和位于 SF（AOR=4.88；95%CI=1.94-12.28）的 NPSS 可能性显著更高。这些结果表明，NPSS 受到药剂师看法的影响。通过对药剂师，特别是那些非连锁药店的药剂师进行更多的教育，可以增加 NPSS。
