title: Is point of access to needles and syringes related to needle sharing? Comparing data collected from pharmacies and needle and syringe programs in south-east Sydney.
abstract: OBJECTIVE
  The comprehensive needle and syringe distribution system in New South Wales is partly based on the premise that different points of access to injecting equipment may attract different groups of injecting drug users. This paper examines patterns of equipment acquisition and risk for blood-borne virus transmission among injecting drug users who use pharmacies and needle and syringe programs (NSP) in south-east Sydney.
  
  
  METHODS
  Clients obtaining injecting equipment from four NSP (n = 147) and eight pharmacies (n = 227) in 2006 voluntarily completed a self-administered questionnaire. Respondents were grouped into three categories based on their needle and syringe acquisition patterns: exclusive use of NSP, exclusive use of pharmacies and use of both.
  
  
  RESULTS
  Although it was common for respondents to report using both pharmacies and NSP to obtain needles and syringes (57%), a proportion reported exclusive use of pharmacies (17%) and NSP (14%). Exclusive pharmacy users were more likely to have never received treatment for their drug use and the least likely to have had a recent test for hepatitis C. Compared with respondents who exclusively used NSP, respondents who exclusively used pharmacies were more likely to report receptive sharing of injecting equipment (adjusted odds ratio 5.9, 95% confidence interval 2.02-17.14), as were respondents who reported using both sources (adjusted odds ratio 5.8, 95% confidence interval 2.35-14.40).
  
  
  CONCLUSIONS
  The high prevalence of receptive equipment sharing among pharmacy clients indicates a need to improve access to needles and syringes and ancillary equipment, possibly by including ancillary equipment at no cost in existing pre-packaged pharmacy products.
authors.affiliation: National Centre in HIV Social Research, University of New South Wales, Sydney, NSW 2052, Australia. j.bryant@unsw.edu.au
authors.forename: Joanne
authors.initials: J
authors.lastname: Bryant
authors.forename: Libby
authors.initials: L
authors.lastname: Topp
authors.forename: Max
authors.initials: M
authors.lastname: Hopwood
authors.forename: Jenny
authors.initials: J
authors.lastname: Iversen
authors.forename: Carla
authors.initials: C
authors.lastname: Treloar
authors.forename: Lisa
authors.initials: L
authors.lastname: Maher
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing / Q000009:adverse effects / Q000706:statistics & numerical data*; D018671:Needle-Exchange Programs / Q000331:legislation & jurisprudence / Q000379:methods / Q000706:statistics & numerical data*; D009517:New South Wales / Q000453:epidemiology; D010594:Pharmacies / Q000592:standards / Q000639:trends; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology* / Q000628:therapy*; D011795:Surveys and Questionnaires; D013594:Syringes / Q000009:adverse effects; D055815:Young Adult