Alan Neaigus, PhD¹, V. Anna Gyarmathy, MS, MPH¹, Maureen Miller, PhD², Veronica M. Frajzyngier, MPH³, Samuel R. Friedman, PhD⁴, and Don C. Des Jarlais, PhD⁵. (1) Institute for International Research on Youth at Risk, National Development and Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York City, NY 10010, 212-845-4480, neaigus@ndri.org, (2) Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 1210, New York City, NY 10032, (3) National Development and Research Institute (NDRI), 71 West 23rd Street, 8th floor, New York City, NY 10010, (4) Institute for AIDS Research, National Development and Research Institutes, 71 West 23d Street, New York, NY 10010, (5) Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, 1st Avenue and 16th Street, New York, NY 10003

Objectives: To examine temporal trends in injecting/sexual HIV/related-infection risk among young injecting drug users (YIDUs) in New York City (NYC), 2/1999-1/2003, before and after pharmacy-based syringe sales (ESAP) were introduced (01/2001). Methods: YIDUs aged 18-30 (N=335) were non-treatment recruited in Lower Manhattan 2/1999-1/2003 and interviewed at baseline. Cross-sectional temporal trends ((y1) 2/1999-1/2000(n=93); (y2) 2/2000-1/2001(n=83)); (y3) 2/2001-1/2002(n=39); and (y4) 2/2002-1/2003(n=120)) are analyzed for 30-day injecting/sexual risk and syringe acquisition sources using multivariate logistic and linear regression, controlling for gender, age, race/ethnicity, and years of injecting. Results: The mean age was 23.3, 68% were male, 81% white, and 83% injecting ?6 years. Receptive syringe sharing did not change significantly (20%(y1)-16%(y4)), but sharing cookers/cotton/rinsewater declined (39%(y1)-22%(y4), p<0.04). Legal syringe acquisition remained stable (78%(y1)-85%(y4)). Acquisition of all syringes from syringe exchange programs (SEPs) declined (72%(y1),72%(y2),49%(y3),47%(y4), p=0.0002), while acquisition of all syringes from pharmacies increased (2%(y1), 1%(y2), 18%(y3), 30% (y4), p<0.0001). Unprotected sex spiked from 39% (y3) to 59% (y4) (p<0.0001). The mean injecting network size declined (5.2(y1), 2.4(y2), 1.4(y3), 1.3(y4), p<.0001); sex risk network size did not change significantly (1.4(y1)-1.2(y4)). Conclusions: The introduction of ESAP was not coincident with an increase in legal syringe acquisition but rather with a decline in syringe acquisition from SEPs. Receptive syringe sharing may be resistant to further declines, although sharing cookers/cotton/rinsewater and injecting network size decreased. Sexual risk increased dramatically. As well as injecting risk, ESAP and interventions among YIDUs must address sexual risk and be able to adapt to sudden changes in the risk environment.

Learning Objectives: At the conclusion of the session, the session participant will be able to

• Understand recent temporal trends in injecting and sexual risks and syringe acquisition sources among young injecting drug users (YIDUs).
• Describe trends in relation to the introduction of the ESAP in New York City.
• Use this information to inform interventions among YIDUs.

Keywords: Intravenous Drug Use, HIV Risk Behavior

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.