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Spatial access to syringe exchange programs and pharmacies selling over-the-counter syringes as predictors of drug injectors' use of sterile syringes

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  • Cooper, H.L.F.
  • Des Jarlais, D.C.
  • Ross, Z.
  • Tempalski, B.
  • Bossak, B.
  • Friedman, S.R.

Abstract

Objectives: We examined relationships of spatial access to syringe exchange programs (SEPs) and pharmacies selling over-the-counter (OTC) syringes with New York City drug injectors' harm reduction practices. Methods: Each year from 1995 to 2006, we measured the percentage of 42 city health districts' surface area that was within 1 mile of an SEP or OTC pharmacy. We applied hierarchical generalized linear models to investigate relationships between these exposures and the odds that injectors (n=4003) used a sterile syringe for at least 75% of injections in the past 6 months. Results: A 1-unit increase in the natural log of the percentage of a district's surface area within a mile of an SEP in 1995 was associated with a 26% increase in the odds of injecting with a sterile syringe; a 1-unit increase in this exposure over time increased these odds 23%. A 1-unit increase in the natural log of OTC pharmacy access improved these odds 15%. Conclusions: Greater spatial access to SEPs and OTC pharmacies improved injectors' capacity to engage in harm reduction practices that reduce HIV and HCV transmission.

Suggested Citation

  • Cooper, H.L.F. & Des Jarlais, D.C. & Ross, Z. & Tempalski, B. & Bossak, B. & Friedman, S.R., 2011. "Spatial access to syringe exchange programs and pharmacies selling over-the-counter syringes as predictors of drug injectors' use of sterile syringes," American Journal of Public Health, American Public Health Association, vol. 101(6), pages 1118-1125.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2009.184580_0
    DOI: 10.2105/AJPH.2009.184580
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    Cited by:

    1. Daniel O’Keefe & Anna Wilkinson & Campbell Aitken & Paul Dietze, 2018. "Geo-spatial analysis of individual-level needle and syringe coverage in Melbourne, Australia," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-13, December.
    2. Hannah L F Cooper & Sabriya Linton & Mary E Kelley & Zev Ross & Mary E Wolfe & Yen-Tyng Chen & Maria Zlotorzynska & Josalin Hunter-Jones & Samuel R Friedman & Don C Des Jarlais & Barbara Tempalski & E, 2016. "Risk Environments, Race/Ethnicity, and HIV Status in a Large Sample of People Who Inject Drugs in the United States," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-21, March.

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