0
Research
Expanding access to sterile syringes through pharmacies: Assessment of New York's Expanded Syringe Access Program
James M. Tesoriero, PhD; Haven B. Battles, PhD; Susan J. Klein, MS; Erin Kaufman, MPH; Guthrie S. Birkhead, MD, MPH
J Am Pharm Assoc (2003) 2009;49:407-416. doi:10.1331/JAPhA.2009.07127

Abstract

Objectives  To investigate the evolution of pharmacist practices, attitudes, and experiences with the Expanded Syringe Access Program (ESAP), which permits over-the-counter sale of syringes by registered pharmacies in New York State.

Design  Longitudinal study.

Setting  New York State in 2002 and 2006.

Participants  506 (2002) and 682 (2006) managing pharmacists (response rates ∼70%) at ESAP-registered pharmacies (n = 346 in both years).

Intervention  Mailed surveys (2002 and 2006).

Main outcome measures  Pharmacist practices, attitudes, and experiences with ESAP over time.

Results  Approximately 75% of pharmacists reported that ESAP had facilitated timely/emergency access to syringes, and more than 90% in each year reported no problems or very few problems administering ESAP. The practice of placing additional requirements on the sale of syringes decreased from 2002 (51.4%) to 2006 (45.1%), while a 55% increase in syringe sales was reported between 2002 (43.3/month) and 2006 (67.1/month). The sale of sharps containers also increased between 2002 (85.2%) and 2006 (92.8%). Community independent pharmacies and those located outside New York City generally expressed more favorable attitudes and experiences with ESAP, although these differences decreased over time.

Conclusion  Pharmacy-based syringe access is a viable harm-reduction alternative in the fight against blood-borne diseases, with ESAP now equaling the number of syringes being distributed by syringe exchange programs in New York State. Continued education/training is necessary to increase participation in ESAP and to further reduce barriers to ESAP use.

Sign In
APhA Members 
Welcome to JAPhA.org! Please log in below using your APhA username and password. Update your APhA profile.
Not a Subscriber
New to JAPhA? Become an APhA member to receive a full subscription to both the print and online editions.

OR

Register for a FREE limited account to benefit from personalization features such as alerts.

References

 New York State Department of Health. New York State HIV/AIDS surveillance semiannual report for cases diagnosed through June 2005: Table 4A. Accessed at www.health.state.ny.us/diseases/aids/statistics/semiannual/2005/surveillance_semiannual_report_2005_june.pdf, March 15,  2008.
 
 Centers for Disease Control and Prevention. Hepatitis surveillance report no. 60: 2005. Accessed at www.cdc.gov/ncidod/diseases/hepatitis/resource/PDFs/hep_surveillance_60.pdf, March 15,  2008.
 
Singer M, Stopka T, Siano C, et al. The social geography of AIDS and hepatitis risk: qualitative approaches for assessing local differences in sterile-syringe access among injection drug users. Am J Public Health. 2000;90:1049–56.[PubMed][CrossRef]
 
Golub ET, Strathdee SA, Bailey SL, et al. Distributive syringe sharing among young adult injection drug users in five U.S. cities. Drug Alcohol Depend. 2007;91(suppl 1):S30–8.[PubMed]
 
Celentano DD, Munoz A, Cohn S, Vlahov D. Dynamics of behavioral risk factors for HIV/AIDS: a 6-year prospective study of injection drug users. Drug Alcohol Depend. 2001;61:315–22.[PubMed]
 
Paone D, Des Jarlais DC, Gangloff R, et al. Syringe exchange: HIV prevention, key findings, and the future directions. Int J Addict. 1995;30:1647–83.[PubMed]
 
Des Jarlais DC, Marmor M, Paone D, et al. HIV incidence among injecting drug users in New York City syringe-exchange programmes. Lancet. 1996;348:987–91.[PubMed]
 
Heimer R, Khoshnood K, Bigg D, et al. Syringe use and reuse: effects of syringe exchange programs in four cities. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;18(suppl 1):S37–44.[PubMed]
 
Vlahov D, Junge B. The role of needle exchange programs in HIV prevention. Public Health Rep. 1998;113(suppl 1):75–80.[PubMed]
 
Bluthenthal RN, Kral AH, Gee L, et al. The effect of syringe exchange use on high-risk drug users: a cohort study. J Acquir Immune Defic Syndr Hum Retrovirol. 2000;14:605–11.
 
Hagan H, Thiede H. Changes in injection risk behavior associated with participation in the Seattle needle-exchange program. J Urban Health. 2000;77:369–82.[PubMed]
 
Des Jarlais DC, Perlis T, Friedman SR, et al. Behavioral risk reduction in a declining HIV epidemic: injection drug users in New York City, 1990-1997. Am J Public Health. 2000;90:1112–6.[PubMed]
 
Longshore D, Bluthenthal RN, Stein M. Needle exchange program attendance and injection risk in Providence, Rhode Island. AIDS Educ Prev. 2001;13:78–90.[PubMed]
 
Gibson D, Leamon MH, Flynn N. Epidemiology and public health consequences of methamphetamine use in California's Central Valley. J Psychoative Drugs. 2002;34:313–9.
 
 State of New York. Public health law: book 44, article 33, title 7, section 3381. St. Paul, MN:  West Publishing.
 
Klein SJ, Birkhead GS, Candelas AR. Expanded Syringe Access Demonstration Program (ESAP) in New York State (NYS): an intervention to prevent HIV transmission. J Urban Health. 2000;77:762–7.[PubMed]
 
Gleghorn AA, Gee G, Vlahov D. Pharmacists’ attitudes about pharmacy sale of needles/syringes and needle exchange programs in a city without needle/syringe prescription laws. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;18(suppl 1):S89–93.
 
Case P, Beckett GA, Jones TS. Access to sterile syringes in Maine: pharmacy practice after the 1993 repeal of the syringe prescription law. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;18(suppl 1):S94–101.[PubMed]
 
Valleroy LA, Weinstein B, Jones TS, et al. Impact of increased legal access to needles and syringes on community pharmacies’ needle and syringe sales-Connecticut, 1992-1993. J Acquir Immune Defic Syndr Hum Retrovirol. 1995;10:73–81.[PubMed]
 
Wright-DeAguero L, Weinstein B, Jones TS, Miles J. Impact of the change in Connecticut syringe prescription laws on pharmacy sales and pharmacy managers’ practices. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;18(suppl 1):S102–10.[PubMed]
 
Harbke CR, Fisher DG, Cagle HH, et al. Telephone survey of Alaskan pharmacists’ nonprescription needle-selling practices. J Urban Health. 2000;77:113–20.[PubMed]
 
Deibert RJ, Goldbaum G, Parker TR, et al. Increased access to unrestricted pharmacy sales of syringes in Seattle-King County, Washington: structural and individual-level changes, 1996 versus 2003. Am J Public Health. 2006;96:1347–53.[PubMed]
 
Coffin PO, Linas BP, Factor SH, Vlahov D. New York City pharmacists’ attitudes toward sale of needles/syringes to injection drug users before implementation of law expanding syringe access. J Urban Health. 2000;77:781–93.[PubMed]
 
Linas BP, Coffin PO, Backes G, Vlahov D. New York State pharmacists’ attitudes toward needle and syringe sales to injection drug users before implementation of syringe deregulation. J Urban Health. 2000; 77:768–80.[PubMed]
 
Klein S, Harris-Valente K, Candelas AR, et al. What do pharmacists’ think about New York State's new non-prescription syringe sale program? Results of a survey. J Urban Health. 2001;78:679–89.[PubMed]
 
Coffin P, Ahern J, Dorris S, et al. More pharmacists in high-risk neighborhoods of New York City support selling syringes to injections drug users. J Am Pharm Assoc. 2002;42(suppl 2):62–7.
 
Des Jarlais DC, McKnight C, Friedmann P. Legal syringe purchases by injection drug users, Brooklyn and Queens, New York City, 2000-2001. J Am Pharm Assoc. 2002;42(suppl 2):73–6.
 
Deren S, Cleland CM, Fuller C, et al. The impact of syringe deregulation on sources of syringes for injection drug users: preliminary findings. AIDS Behav. 2006;10:717–21.[PubMed]
 
Fuller C, Ahern J, Vadnai L, et al. Impact of increased syringe access: preliminary findings on injection drug user syringe source, disposal, and pharmacy sales in Harlem, New York. J Am Pharm Assoc. 2002;42(suppl 2):77–82.
 
Fuller CM, Galea S, Blaney S, et al. Explaining the relationship between race/ethnicity and pharmacy purchased syringes among injection drug users in New York City. Ethn Dis. 2004;14:589–96.[PubMed]
 
Fuller CM, Galea S, Caceres W, et al. Multilevel community-based intervention to increase access to sterile syringes among injection drug users through pharmacy sales in New York City. Am J Public Health. 2007;97:117–24.[PubMed]
 
Cleland CM, Deren S, Fuller CM, et al. Syringe disposal among injection drug users in Harlem and the Bronx during the New York State Expanded Syringe Access Demonstration Program. Health Educ Behav. 2007;34:390–403[PubMed]
 
 New York State Department of Health/AIDS Institute. The Community Need Index report series: 2000 edition. Accessed at www.health.state.ny.us/diseases/aids/reports/cniinfo.htm, March 15,  2008.
 
Klein SJ, Candelas AR, Cooper JG, et al. Increasing safe syringe collection sites in New York State. Public Health Rep. 2008;123:433–40.[PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Please read the other comments before you post yours. Comments are moderated and will appear on the site at the discertion of the editorial staff.
* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content

Customize your page view by dragging & repositioning the boxes below.

JAPhA Articles
Topic Collections
PubMed Articles
Advertisement
 
  • Print
  • PDF Download
  • Email
  • Share
  • Get Citation
  • Submit Comment
  • Article Alerts
    Please Wait... Processing your request... Please Wait.
    You must sign in to sign-up for alerts.

    Please confirm that your email address is correct, so you can successfully receive this alert.

  • Letters To Editor
  • Reprints