title: Multilevel community-based intervention to increase access to sterile syringes among injection drug users through pharmacy sales in New York City.
abstract: OBJECTIVE
  Research has indicated that there is minimal use of pharmacies among injection drug users (IDUs) in specific neighborhoods and among Black and Hispanic IDUs. We developed a community-based participatory research partnership to determine whether a multilevel intervention would increase sterile syringe access through a new policy allowing nonprescription syringe sales in pharmacies.
  
  
  METHODS
  We targeted Harlem, NY (using the South Bronx for comparison), and disseminated informational material at community forums, pharmacist training programs, and counseling or outreach programs for IDUs. We compared cross-sectional samples in 3 target populations (pre- and postintervention): community members (attitudes and opinions), pharmacists (opinions and practices), and IDUs (risk behaviors).
  
  
  RESULTS
  Among community members (N = 1496) and pharmacists (N = 131), negative opinions of IDU syringe sales decreased in Harlem whereas there was either no change or an increase in negative opinions in the comparison community. Although pharmacy use by IDUs (N=728) increased in both communities, pharmacy use increased significantly among Black IDUs in Harlem, but not in the comparison community; syringe reuse significantly decreased in Harlem, but not in the comparison community.
  
  
  CONCLUSIONS
  Targeting the individual and the social environment through a multilevel community-based intervention reduced high-risk behavior, particularly among Black IDUs.
authors.affiliation: Harlem Community & Academic Partnership at the Center for Urban Epidemiological Studies, New York Academy of Medicine, New York, NY, USA. cf317@columbia.edu
authors.forename: Crystal M
authors.initials: CM
authors.lastname: Fuller
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
authors.forename: Wendy
authors.initials: W
authors.lastname: Caceres
authors.forename: Shannon
authors.initials: S
authors.lastname: Blaney
authors.forename: Sarah
authors.initials: S
authors.lastname: Sisco
authors.forename: David
authors.initials: D
authors.lastname: Vlahov
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000193:education*; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D018672:Community Health Planning; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control*; D006266:Health Education; D006302:Health Services Research; D006630:Hispanic or Latino / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D010594:Pharmacies / Q000458:organization & administration* / Q000706:statistics & numerical data; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012931:Social Environment; D015819:Substance Abuse, Intravenous / Q000208:ethnology* / Q000821:virology; D013594:Syringes / Q000600:supply & distribution*; D019037:Urban Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data