title: Pharmacy-randomized intervention delivering HIV prevention services during the syringe sale to people who inject drugs in New York City.
abstract: BACKGROUND
  Pharmacy syringe access may be an opportunity to provide HIV prevention resources to persons who inject drugs (PWID). We examined the impact of a pharmacy-randomized intervention to reduce injection risk among PWID in New York City.
  
  
  METHODS
  Pharmacies (n=88) were randomized into intervention, primary control, and secondary control arms. Intervention pharmacies received in-depth harm reduction training, recruited syringe customers who inject drugs into the study, and provided additional services (i.e., HIV prevention/medical/social service referrals, syringe disposal containers, and harm reduction print materials). Primary control pharmacies recruited syringe customers who inject drugs and did not offer additional services, and secondary control pharmacies did not recruit syringe customers (and are not included in this analysis) but participated in a pharmacy staff survey to evaluate intervention impact on pharmacy staff. Recruited syringe customers underwent a baseline and 3-month follow-up ACASI. The intervention effect on injection risk/protective behavior of PWID was examined.
  
  
  RESULTS
  A total of 482 PWID completed baseline and follow-up surveys. PWID were mostly Hispanic/Latino, male, and mean age of 43.6 years. After adjustment, PWID in the intervention arm were more likely to report always using a sterile syringe vs. not (PR=1.24; 95% CI: 1.04-1.48) at 3-month follow-up.
  
  
  CONCLUSIONS
  These findings present evidence that expanded pharmacy services for PWID can encourage sterile syringe use which may decrease injection risk in high HIV burdened Black and Latino communities.
authors.affiliation: Division of Statistics and Services Research, Nathan S. Kline Institute for Psychiatric Research, State of New York Office of Mental Health, 140 Orangeburg Road, Orangeburg, NY 10962, United States; Department of Psychiatry, New York University School of Medicine, 462 1st Avenue, New York, NY 10016, United States. Electronic address: cf317@columbia.edu.
authors.forename: Crystal Fuller
authors.initials: CF
authors.lastname: Lewis
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, United States.
authors.forename: Alexis V
authors.initials: AV
authors.lastname: Rivera
authors.affiliation: Department of Behavioral Health Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States.
authors.forename: Natalie D
authors.initials: ND
authors.lastname: Crawford
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, United States; College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY 10032, United States.
authors.forename: Jennifer
authors.initials: J
authors.lastname: DeCuir
authors.affiliation: Center for Family and Community Medicine, College of Physicians and Surgeons, Columbia University, 100 Haven Avenue, Suite 27D, New York, NY 10032, United States; Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, United States.
authors.forename: Silvia
authors.initials: S
authors.lastname: Amesty
mesh_terms: D000328:Adult; D003132:Commerce; D003157:Community Pharmacy Services; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000517:prevention & control*; D040261:Harm Reduction; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000191:economics; D013594:Syringes / Q000191:economics*
keywords: HIV prevention; Persons who inject drugs (PWID); Pharmacies; Risk behavior; Structural interventions