Pharmacy-randomized intervention delivering HIV prevention services during the syringe sale to people who inject drugs in New York City. (1st August 2015) - Lewis, Crystal Fuller
Highlights: Racial disparities in HIV burden persist among persons who inject drugs (PWID). We conducted a pharmacy-randomized trial coupling HIV services with syringe buys. At follow-up, we found a positive intervention effect on sterile syringe use. Expanded pharmacy services may decrease injection risk in HIV burdened communities. Abstract: Background: Pharmacy syringe access may be an opportunity to provide HIV prevention resources to persons who inject drugs (PWID). We examined the impact of a pharmacy-randomized intervention to reduce injection risk among PWID in New York City. Methods: Pharmacies ( n = 88) were randomized into intervention, primary control, and secondary control arms. Intervention pharmacies received in-depth harm reduction training, recruited syringe customers who inject drugs into the study, and provided additional services (i.e., HIV prevention/medical/social service referrals, syringe disposal containers, and harm reduction print materials). Primary control pharmacies recruited syringe customers who inject drugs and did not offer additional services, and secondary control pharmacies did not recruit syringe customers (and are not included in this analysis) but participated in a pharmacy staff survey to evaluate intervention impact on pharmacy staff. Recruited syringe customers underwent a baseline and 3-month follow-up ACASI. The intervention effect on injection risk/protective behavior of PWID was examined. Results: A total of 482 PWID completed baseline and follow-up surveys. PWID were mostly Hispanic/Latino, male, and mean age of 43.6 years. After adjustment, PWID in the intervention arm were more likely to report always using a sterile syringe vs. not (PR = 1.24; 95% CI: 1.04–1.48) at 3-month follow-up. Conclusions: These findings present evidence that expanded pharmacy services for PWID can encourage sterile syringe use which may decrease injection risk in high HIV burdened Black and Latino communities.