Wendy Caceres, BA¹, Sarah Sisco, MPH, MSSW¹, Sandro Galea, MD, MPH, DrPH¹, Shannon Blaney, MPH¹, Ann Boyer, MD², Eric Canales¹, Ely Fontanez³, Laurell Lasenberg⁴, Gail Love⁵, Ann-Gel Palermo, MPH⁶, and Crystal Fuller, PhD¹. (1) Center for Urban Epidemiologic Studies (CUES), New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, 212-822-7348, wcaceres@nyam.org, (2) Department of Community and Preventive Medicine, Mount Sinai School of Medicine, 1 Gustav Levy Place, New York, NY 10029, (3) East Harlem HIV Care Network, 158 East 115th Street Room 218, New York, NY 10029, (4) Office of Gay and Lesbian Health, NYC DOH/MH, 158 East 115th Street, New York, NY 10029, (5) Women's Information Network, 1780 1st Avenue Apt 5A, New York, NY 10128, (6) Center for Multicultural and Community Affairs, Mount Sinai School of Medicine, One Gustave Levy Place, Box 1257, New York, NY 10029

The Expanded Syringe Access Demonstration Program (ESAP) became effective January 1, 2001 in New York State, permitting the sale of non-prescription syringes at registered pharmacies. Black and Hispanic injection drug users (IDUs) were found to be less likely to use ESAP in early evaluations. A multi-level community-based intervention was implemented in East and Central Harlem from summer 2002 to summer 2003 to increase ESAP participation using a community-based participatory research model (CBPR). The purpose of this study was to compare attitudes, awareness and practices of IDUs, pharmacists, and community residents in the target community (Harlem) and control community (South Bronx) before and after the ESAP intervention. Data was collected through community surveys among IDUs (N=717), and telephone surveys among pharmacists (N=132) and community residents (N=1391). When comparing pre- vs. post-intervention periods, Harlem community residents who felt ESAP was a good idea increased more (6% vs. 14%;p<0.01) than control community (6% vs. 9%;p<0.17), respectively; Harlem pharmacists who felt ESAP was detrimental to HIV prevention decreased (8% vs. 4%;p<0.04) while pharmacists from control community increased (13% vs. 23%;p<0.16), respectively; and Harlem IDUs used pharmacies more (8% vs. 15%;p<0.05), reused syringes less (11% vs. 7%;p<0.21), and used unsafe disposal practices less (19% vs. 11%;p<0.04) compared to South Bronx IDUs (3% vs. 3%;p<0.24), (8% vs. 8%;p<0.81), and (11% vs. 20%;p<0.12), respectively. Multi-level targeting of community residents, pharmacists, and IDUs using CBPR showed evidence of impact on individual-level behavior.

Learning Objectives:

• Discuss the importance of involving individual and community level factors when implementing new policy aimed at reducing risk among marginalized populations such as injection drug users.
• Structure and evaluate a multi-level intervention.
• Apply methodology involved in community based participatory research.

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.