Multilevel pharmacy-randomized intervention targeting IDUs and pharmacy practice: Impact of providing HIV risk reduction materials during the syringe sale on idu risk behavior

Background: Pharmacies as Resources Making Links to Community Services (PHARM-Link) is a randomized community-based pharmacy intervention aimed at expanding services to injection drug user (IDU) syringe customers in socially disadvantaged neighborhoods in New York City. Methods: Pharmacies (n=88) were randomized into intervention or control arms. Intervention pharmacies received in-depth harm reduction training, recruited IDU syringe customers into the study, and provided additional services such as health/social service referrals, syringe disposal containers, print materials, and harm reduction information from a web resource guide targeted to the substance use community. Pharmacies in the control arm recruited IDUs only. IDUs completed a baseline and 3-month follow-up survey. Intervention outcomes included: 1) use of pharmacies as a primary sterile syringe source, 2) safe syringe disposal, 3) HIV testing, 4) drug abuse treatment, 5) health insurance coverage, and 6) sterile syringe use among IDU syringe customers. Results: A total of 482 IDUs completed baseline and follow-up surveys. IDUs were mostly Hispanic/Latino, male, with a mean age of 43.6 years. After adjustment for demographics and clustering of IDUs within pharmacies, IDUs in the intervention arm were more likely to report pharmacies as their primary syringe source (AOR=1.20;95% CI:1.0-1.43;p=0.05), 100% sterile syringe use (AOR=1.24;95% CI:1.04-1.48;p=0.02), and less likely to report barriers to pharmacy syringe purchases (AOR=0.76;95%CI:0.58-0.99;p=0.04) at 3-month follow-up. Conclusions: These findings present evidence that expanded pharmacy services for IDUs can encourage use of pharmacies as a syringe source and sterile syringe use which may decrease injection risk in high HIV burdened black/Latino communities.