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AJPH First Look, published online ahead of print Nov 30, 2006
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Crystal M. Fuller
Sandro Galea
Wendy Caceres
Shannon Blaney
Sarah Sisco
David Vlahov
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American Journal of Public Health, 10.2105/AJPH.2005.069591

Research and Practice

Multilevel Community-Based Intervention to Increase Access to Sterile Syringes Among Injection Drug Users Through Pharmacy Sales in New York City

Crystal M. Fuller 1*, Sandro Galea 2, Wendy Caceres 2, Shannon Blaney 2, Sarah Sisco 2, David Vlahov 2

1 Columbia University, Mailman School of Public Health and New York Academy of Medicine
2 New York Academy of Medicine

* To whom correspondence should be addressed. E-mail: cf317{at}columbia.edu.


  Abstract

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 3 cohorts in both communities (pre- and postintervention): community members (attitudes and opinions), pharmacists (perceptions and practices), and IDUs (risk behaviors). Results. Among community members (N=1496) and pharmacists (N=131), negative opinions of syringe sales decreased in Harlem, although there was no change or an increase of negative opinions by members in either group in the comparison community. Although pharmacy use by IDUs (N=728) increased in both communities, injection drug use increased significantly among Black IDUs in Harlem, but not in the comparison community; syringe re-use 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.

Key Words: Epidemiology, Health Policy, HIV/AIDS, Race/Ethnicity, Drugs, Urban Health




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