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Receptive Syringe Sharing Among Injection Drug Users in Harlem and the Bronx During the New York State Expanded Syringe Access Demonstration Program

Pouget, Enrique R BA*; Deren, Sherry PhD*; Fuller, Crystal M PhD†‡; Blaney, Shannon MPH; McMahon, James M PhD*; Kang, Sung-Yeon PhD*; Tortu, Stephanie PhD§; Andia, Jonny F PhD*; Des Jarlais, Don C PhD*∥; Vlahov, David PhD

JAIDS Journal of Acquired Immune Deficiency Syndromes: August 1st, 2005 - Volume 39 - Issue 4 - p 471-477
doi: 10.1097/01.qai.0000152395.82885.c0
Epidemiology and Social Science

Background: Effective on January 1, 2001, New York State enacted the Expanded Syringe Access Demonstration Program (ESAP), which allows syringes to be sold in pharmacies without a prescription or dispensed through doctors, hospitals, and clinics to persons 18 years of age or older and permits the possession of those syringes for the purposes of injecting drugs.

Objective: To assess changes in receptive syringe sharing since the inception of the ESAP.

Methods: Sociodemographic characteristics and syringe use data regarding the last injection episode were combined from 3 projects (n = 1181) recruiting injection drug users in ongoing studies in Harlem and the Bronx in New York City from January 2001 through June 2003. These data were analyzed as serial cross sections by calendar quarter.

Results: Receptive sharing decreased significantly over time, from 13.4% in the first quarter to 3.6% in the last quarter. Obtaining the last injection syringe from an ESAP source (mostly pharmacies) increased significantly over time, from 7.5% in the first quarter to 25.0% in the last quarter. In multiple logistic regression analysis, variables that were significantly associated with less receptive sharing were syringe exchange and ESAP syringe source as well as time since ESAP inception. Female gender and white race/ethnicity were significantly associated with greater receptive sharing.

Conclusions: The increase in the use of pharmacies and other ESAP syringe sources in this sample has been accompanied by a decline in receptive sharing.

From the *National Development and Research Institutes, Inc., New York, NY; †Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; ‡Center for Urban Epidemiologic Studies, The New York Academy of Medicine, New York, NY; §Department of Community Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA; and ∥The Edmond de Rothschild Foundation, Chemical Dependency Institute, Beth Israel Medical Center, New York, NY.

Received for publication January 20, 2004; Accepted November 22, 2004.

Supported by grants R01DA014219 (D. Vlahov), R01DA010425 and P30DA011041 (S. Deren), and R01DA012805 (S. Tortu) from the National Institute on Drug Abuse, Rockville, MD, and grant U48/CCU209663 from the Centers for Disease Control and Prevention, Atlanta, GA (D. Vlahov).

Presented in part at the 2003 National HIV Prevention Conference, Atlanta, July 27-30, 2003.

Reprints: Enrique R. Pouget, National Development and Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010 (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.