Spatial access to syringe exchange programs and pharmacies selling over-the-counter syringes as predictors of drug injectors' use of sterile syringes

Am J Public Health. 2011 Jun;101(6):1118-25. doi: 10.2105/AJPH.2009.184580. Epub 2010 Nov 18.

Abstract

Objectives: We examined relationships of spatial access to syringe exchange programs (SEPs) and pharmacies selling over-the-counter (OTC) syringes with New York City drug injectors' harm reduction practices.

Methods: Each year from 1995 to 2006, we measured the percentage of 42 city health districts' surface area that was within 1 mile of an SEP or OTC pharmacy. We applied hierarchical generalized linear models to investigate relationships between these exposures and the odds that injectors (n = 4003) used a sterile syringe for at least 75% of injections in the past 6 months.

Results: A 1-unit increase in the natural log of the percentage of a district's surface area within a mile of an SEP in 1995 was associated with a 26% increase in the odds of injecting with a sterile syringe; a 1-unit increase in this exposure over time increased these odds 23%. A 1-unit increase in the natural log of OTC pharmacy access improved these odds 15%.

Conclusions: Greater spatial access to SEPs and OTC pharmacies improved injectors' capacity to engage in harm reduction practices that reduce HIV and HCV transmission.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Multilevel Analysis
  • Needle-Exchange Programs / supply & distribution*
  • New York City
  • Pharmacies / economics
  • Pharmacies / supply & distribution*
  • Small-Area Analysis
  • Substance Abuse, Intravenous / psychology*
  • Syringes / supply & distribution*
  • Young Adult