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Crystal M. Fuller, MPH, PhD, Sandro Galea, MD, DrPH, Wendy Caceres, BS, Shannon Blaney, MPH, Sarah Sisco, MPH and David Vlahov, PhD

The authors are with the Harlem Community & Academic Partnership at the Center for Urban Epidemiological Studies, New York Academy of Medicine, New York, NY.

Correspondence: Requests for reprints should be sent to Crystal M. Fuller, 722 West 168th Street, Room 718, New York, NY 10032 (e-mail: cf317{at}columbia.edu).

Objectives. Research has indicated that there is minimal use of pharmacies among injection drug users (IDUs) in specific neighborhoods and among Black and Hispanic IDUs. We developed a community-based participatory research partnership to determine whether a multilevel intervention would increase sterile syringe access through a new policy allowing nonprescription syringe sales in pharmacies.

Methods. We targeted Harlem, NY (using the South Bronx for comparison), and disseminated informational material at community forums, pharmacist training programs, and counseling or outreach programs for IDUs. We compared cross-sectional samples in 3 target populations (pre- and postintervention): community members (attitudes and opinions), pharmacists (opinions and practices), and IDUs (risk behaviors).

Results. Among community members (N = 1496) and pharmacists (N = 131), negative opinions of IDU syringe sales decreased in Harlem whereas there was either no change or an increase in negative opinions in the comparison community. Although pharmacy use by IDUs (N=728) increased in both communities, pharmacy use increased significantly among Black IDUs in Harlem, but not in the comparison community; syringe reuse significantly decreased in Harlem, but not in the comparison community.

Conclusions. Targeting the individual and the social environment through a multilevel community-based intervention reduced high-risk behavior, particularly among Black IDUs.

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