title: Reality and feasibility for pharmacy-delivered services for people who inject drugs in Xichang, China: Comparisons between pharmacy staff and people who inject drugs.
abstract: BACKGROUND
  In 2010, the reported overall HIV prevalence in Liangshan China (1.14%) was 19.7 times of the overall estimated prevalence in China (0.058%), and injection drug use contributed to 60.0% of overall HIV infections in Xichang, the Capital city of Liangshan. With one national methadone clinic and three outpatient service sites, and three NEP sites, the HIV prevalence among people who inject drugs (PWID) in Xichang was estimated as 18.0% (2.8 times of national HIV prevalence among PWID) in 2012.
  
  
  METHODS
  Face-to-face questionnaire interviews were used in a cross-sectional study to assess experience, attitudes, possibility and acceptability of implementing 8 pharmacy-delivered services among PWID (n=403). The concordance of attitudes, possibility and acceptability between PWID and pharmacy staff (n=50) was examined.
  
  
  RESULTS
  Rather than medical facility (23.1%), and NEP (8.9%), pharmacies were the main source of syringes for PWID in the last 12 months (82.1%), PWID (63.5%) reported syringes could be bought in single piece and at the price of $0.16 USD (59.3%). In the last 30 days, only 1 PWID brought used syringes back to a pharmacy. Pharmacy staff's attitudes were generally negative but nearly neutral (average score -0.18), discrimination/business concerns against pharmacy-delivered services existed, and 4 of 5 compared attitude questions between PWID and pharmacy staff were statistically different (p<0.01). 5 of 8 pharmacy-delivered services were available for PWID at low level (≤16.9%). Pharmacy staff's supportive perception for pharmacy-delivered services focused on pharmacies' initiate roles targeting on general population more than on PWID. PWID were more supportive and optimistic than pharmacy staff toward potential usage of pharmacy-delivered services (p<0.05).
  
  
  CONCLUSIONS
  Pharmacy-delivered services for PWID in Xichang were partly in reality, and could be feasible. It is urgently needed to address the legal requirements and remuneration for pharmacies. Pharmacy staff should receive additional training on services related knowledge and skills, cultural sensitivity toward PWID. Successful pharmacy-delivered services would benefit from identifying mutual interest and benefit between pharmacies and PWID.
authors.affiliation: Department of Social Medicine and Health Administration, School of Administration, Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wengjiang District, Chengdu 611137, China; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry St. 2nd FL, Baltimore, MD 21205, United States.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry St. 2nd FL, Baltimore, MD 21205, United States. Electronic address: carl.latkin@jhu.edu.
authors.forename: Carl
authors.initials: C
authors.lastname: Latkin
authors.affiliation: Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Rongsheng
authors.initials: R
authors.lastname: Luan
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry St. 2nd FL, Baltimore, MD 21205, United States.
authors.forename: Cui
authors.initials: C
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage; D008875:Middle Aged; D018671:Needle-Exchange Programs / Q000458:organization & administration; D010593:Pharmaceutical Services / Q000458:organization & administration*; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D008691:Methadone
keywords: China; HIV; PWID; Pharmacies; Services; Yi ethnic group