Impact of expanding syringe access in New York on sources of syringes for injection drug users in Harlem and the Bronx, NYC, USA

Beginning in January 2001, it became legal for pharmacies, health care facilities and certain health care providers in New York State (NYS) to sell or provide syringes (10 maximum) without prescription. Cross-sectional survey data from three research projects recruiting active injection drug users (IDUs) in Harlem and the South Bronx (n=682) were analysed by calendar quarter, from January 2001 through September 2002, to assist in an evaluation of the impact of the program, the Expanded Syringe Access Demonstration Program (ESAP). The outcome variable examined was having used a pharmacy as the source of the last injection syringe. The percent of IDUs who knew that it was legal to buy a syringe from a pharmacy increased over time (25–54%, P<0.001). Pharmacy as the source of the last injection syringe increased to approximately 20%, and syringe exchange programmes (SEPs) remained the most common source (approximately 50%). In a multiple logistic regression analysis, IDUs who knew it was legal were more likely to have purchased their last syringe from a pharmacy (AOR=4.65, CI=2.58–8.36). Pharmacies were more likely to be used by those who were younger (AOR=0.96, CI=0.93–0.99) and those who were White (AOR=2.55, CI=1.30–5.00), and calendar quarter was a significant independent predictor of pharmacy use (AOR=1.22, CI=1.06–1.40). Overall, these data indicate that: (a) knowledge about the option of purchasing syringes from a pharmacy has increased, but enhanced dissemination efforts to IDUs, especially particular sub-groups, are needed; and (b) pharmacies were becoming a supplemental source of syringes for active IDUs (in communities served by SEPs).