As part of two large studies of active injection drug users (IDUs), we have collected information on syringe access patterns and HIV- and hepatitis-related risk behaviors in Hartford and New Haven, CT, Chicago, IL, and Oakland, CA. Despite the presence of syringe exchange programs (SEPs) in each city and the legal availability of syringes through pharmacies in CT and IL, not all IDUs obtained their syringes directly from these safe sources. Many report obtaining syringes from other injectors, street sellers, or among syringes publicly discarded. Our analysis identified the extent of risky injection practices among IDUs and determined, using both syringe tracking methods and self-report, that a large percentage of IDUs who do not go to the SEP themselves nevertheless obtained syringes from associates who did. Furthermore, the percentage of IDUs obtaining syringes from unsafe sources and the frequency at which they did so varied among neighborhoods. We divided cities into discrete neighborhoods which possess one or both safe sources -- pharmacies that sell without a prescription or a SEP site -- and those which possess neither. Neighborhoods with more access through safe sources have fewer IDUs who did not, either directly or indirectly, get clean, sterile syringes from reliable sources than neighborhoods without safe sources. In addition, we have observed that IDUs who obtained syringes from pharmacies, where they have to pay, differed from IDUs who obtained syringes from SEPs in terms of their likelihood to dispense clean, sterile syringes to other injectors.
Learning Objectives: To disseminate information about injection-related HIV and hepatitis risk amongst drug injectors not availing themselves of safe sources for syringes and to explore the correlation between neighborhood variations in access to safe sources and the level of individual and composite risk.
Keywords: HIV Risk Behavior, Injection Drug Users
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.