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Syringe Acquisition Experiences and Attitudes among Injection Drug Users Undergoing Short-Term Opioid Detoxification in Massachusetts and Rhode Island

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Abstract

Access to sterile syringes for injection drug users (IDUs) is a critical part of a comprehensive strategy to combat the transmission of HIV, hepatitis C virus, and other bloodborne pathogens. Understanding IDUs’ experiences and attitudes about syringe acquisition is crucial to ensuring adequate syringe supply and access for this population. This study sought to assess and compare IDUs’ syringe acquisition experiences and attitudes and HIV risk behavior in two neighboring states, Massachusetts (MA) and Rhode Island (RI). From March 2008 to May 2009, we surveyed 150 opioid IDUs at detoxification facilities in MA and RI, stratified the sample based on where respondents spent most of their time, and generated descriptive statistics to compare responses among the two groups. A large proportion of our participants (83%) reported pharmacies as a source of syringe in the last 6 months, while only 13% reported syringe exchange programs (SEPs) as a syringe source. Although 91% of our sample reported being able to obtain all of the syringes they needed in the past 6 months, 49% had used syringes or injection equipment previously used by someone else in that same time period. In comparison to syringe acquisition behaviors reported by patients of the same detoxification centers in 2001–2003 (data reported in previous publication), we found notable changes among MA participants. Our results reveal that some IDUs in our sample are still practicing high-risk injection behaviors, indicating a need for expanded and renewed efforts to promote safer injection behavior among IDUs. Our findings also indicate that pharmacies have become an important syringe source for IDUs and may represent a new and important setting in which IDUs can be engaged in a wide array of health services. Efforts should be made to involve pharmacists in providing harm reduction and HIV prevention services to IDUs. Finally, despite limited SEP access (especially in MA), SEPs are still used by approximately one of the three IDUs in our overall sample.

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Acknowledgments

This work was supported in part by award number K24DA022112 from the National Institutes of Health, National Institute on Drug Abuse (NIH/NIDA) and by grant number P30-AI-42853 from the National Institutes of Health, Center for AIDS Research (NIH/CFAR). This work was also made possible in part through the support of training grant number 5T32DA013911 from the National Institutes of Health, National Institute on Drug Abuse (NIH/NIDA). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of NIH, NIDA, or CFAR. The authors would like to thank the staff at SSTAR for their assistance.

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Authors and Affiliations

  1. Division of Infectious Diseases, The Miriam Hospital, Providence, RI, USA

    Nickolas D. Zaller, Michael A. Yokell, Sandeep M. Nayak, Jeannia J. Fu, Alexander R. Bazazi & Josiah D. Rich

  2. Center for AIDS Research, The Miriam Hospital, Providence, RI, USA

    Nickolas D. Zaller, Michael A. Yokell, Sandeep M. Nayak, Jeannia J. Fu, Alexander R. Bazazi & Josiah D. Rich

  3. Warren Alpert Medical School of Brown University, Providence, RI, USA

    Nickolas D. Zaller & Josiah D. Rich

  4. Stanford University School of Medicine, Stanford, CA, USA

    Michael A. Yokell

  5. Brown University, Providence, RI, USA

    Sandeep M. Nayak

  6. Yale School of Medicine, New Haven, CT, USA

    Jeannia J. Fu & Alexander R. Bazazi

Authors
  1. Nickolas D. Zaller
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  2. Michael A. Yokell
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  3. Sandeep M. Nayak
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  4. Jeannia J. Fu
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  5. Alexander R. Bazazi
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  6. Josiah D. Rich
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Correspondence to Nickolas D. Zaller.

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Zaller, N.D., Yokell, M.A., Nayak, S.M. et al. Syringe Acquisition Experiences and Attitudes among Injection Drug Users Undergoing Short-Term Opioid Detoxification in Massachusetts and Rhode Island. J Urban Health 89, 659–670 (2012). https://doi.org/10.1007/s11524-012-9669-7

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  • DOI: https://doi.org/10.1007/s11524-012-9669-7

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