2023 年亚利桑那州秘密购物者研究：当您感染时再来：药房获得无菌注射器的机会。
Come back when you're infected: pharmacy access to sterile syringes in an Arizona Secret Shopper Study, 2023.
机构信息
Arizona State University, Tempe, AZ, USA.
Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA.
出版信息
Harm Reduct J. 2024 Feb 22;21(1):49. doi: 10.1186/s12954-024-00943-w.
BACKGROUND
Pharmacies are critical healthcare partners in community efforts to eliminate bloodborne illnesses. Pharmacy sale of sterile syringes is central to this effort.
METHODS
A mixed methods "secret shopper" syringe purchase study was conducted in the fall of 2022 with 38 community pharmacies in Maricopa and Pima Counties, Arizona. Pharmacies were geomapped to within 2 miles of areas identified as having a potentially high volume of illicit drug commerce. Daytime venue sampling was used whereby separate investigators with lived/living drug use experience attempted to purchase syringes without a prescription. Investigator response when prompted for purchase rationale was "to protect myself from HIV and hepatitis C." A 24-item instrument measured sales outcome, pharmacy staff interaction (hostile/neutral/friendly), and the buyer's subjective experience.
RESULTS
Only 24.6% (n = 28) of 114 purchase attempts across the 38 pharmacies resulted in syringe sale. Less than one quarter (21.1%) of pharmacies always sold, while 44.7% never sold. Independent and food store pharmacies tended not to sell syringes. There emerged distinct pharmacy staff interactions characterized by body language, customer query, normalization or othering response, response to purchase request and closure. Pharmacy discretion and pharmacy policy not to sell syringes without a prescription limited sterile syringe access. Investigators reported frequent and adverse emotional impact due to pharmacy staff negative and stigmatizing interactions.
CONCLUSIONS
Pharmacies miss opportunities to advance efforts to eliminate bloodborne infections by stringent no-sale policy and discretion about syringe sale. State regulatory policy facilitating pharmacy syringe sales, limiting pharmacist discretion for syringe sales, and targeting pharmacy-staff level education may help advance the achievement of public health goals to eliminate bloodborne infections in Arizona.
背景
药店是社区消除血源性疾病努力的重要医疗合作伙伴。药店销售无菌注射器是这项工作的核心。
方法
2022 年秋季，在亚利桑那州马里科帕县和皮马县的 38 家社区药店进行了一项混合方法的“秘密购物者”注射器购买研究。药店按照距离被认为存在大量非法毒品交易的区域 2 英里以内进行地理映射。采用日间场地抽样法，有吸毒经历的调查员试图在没有处方的情况下购买注射器。当被问及购买理由时，调查员的回答是“保护自己免受 HIV 和丙型肝炎的感染”。一项 24 项的量表衡量了销售结果、药店员工互动（敌对/中立/友好）和购买者的主观体验。
结果
在 38 家药店的 114 次购买尝试中，只有 24.6%（n=28）成功购买了注射器。不到四分之一（21.1%）的药店总是出售，而 44.7%的药店从不出售。独立药店和杂货店往往不销售注射器。药店员工的互动方式各不相同，包括身体语言、客户询问、正常化或污名化的反应、对购买请求的反应和结束。药店的自由裁量权和不出售无处方的注射器的政策限制了无菌注射器的获取。调查员报告说，由于药店员工的负面和污名化的互动，他们经常感到情绪受到影响。
结论
由于严格的不销售政策和对注射器销售的自由裁量权，药店错失了推进消除血源性感染努力的机会。州监管政策促进药店注射器销售，限制药剂师对注射器销售的自由裁量权，并针对药店员工层面的教育，可能有助于实现亚利桑那州消除血源性感染的公共卫生目标。
Zotero 插件