Rich JD, McKenzie M, Sanford-Colby SL, Wolf FA, Taylor LE, Anastacio CL, Torres Z, McNamara SF, Macalino GE; National HIV Prevention Conference (2003 : Atlanta, Ga.).
Abstr Book 2003 Natl HIV Prev Conf July 27 30 2003 Hyatt Regency Atlanta Hotel Atlanta Ga Natl HIV Prev Conf 2003 Atlanta Ga. 2003; abstract no. T3-C1403.
The Miriam Hospital/Brown University, Providence, RI
ISSUE: IDUs often share and re-use syringes due to a lack of legal access to syringes and are at increased risk for many medical conditions, yet frequently are alienated from healthcare services. Having physicians prescribe syringes to IDUs facilitates access both to sterile syringes and medical providers. Physician syringe prescription can also provide a conduit to other needed services, including substance abuse treatment. SETTING: Two walk-in clinical sites in Providence, Rhode Island. PROJECT: A pilot intervention of physician syringe prescription was initiated in 1999 to reduce syringe sharing, provide access to health care services, and increase access to substance abuse treatment and other IDU-relevant services. Participant's receive free medical care, including HIV, hepatitis and syphilis testing, risk reduction counseling and, if appropriate, hepatitis B vaccination. Participants who report they will continue to inject also receive a prescription for sterile syringes, instruction on safe syringe disposal and a biohazard bucket. Follow-up medical appointments are scheduled as needed. Follow-up interviews are scheduled at enrollment, 3, 6, and 12 months.RESULTS: Between June 1999 and December 2000, we recruited 327 participants. Project participants are 55% white, 25% African American, 14% Latino and 33% female. Almost 80% of participants report being homeless in their lifetime and 45% report being homeless at time of enrollment. At baseline, 43% of participants report sharing syringes within the last 30 days and reusing their syringe an average of 8 times. Only 20% of participants report obtaining syringes from a reliable source, such as needle exchange programs or pharmacies. Thirty-seven percent report having a primary care physician; 41% report having insurance; 68% report going to the emergency room in the last year and 42% report using the emergency room for their basic healthcare needs. Two pharmacies have been actively involved since program initiation. Seven doctors have staffed the program. Providers regularly refer participants to medical specialty care, substance abuse treatment, domestic violence shelters, mental health services, meal programs, housing services, and financial assistance programs. LESSONS LEARNED: This is the first study to explore syringe prescription as a strategy to reduce the transmission of HIV and hepatitis in IDUs. Thus far, physician-patient and pharmacist-patient interactions are positive. Syringe prescription provides a "hook" into care and encourages an on-going clinical relationship, which provides a basis for medical care, substance abuse treatment and social service interventions and linkages. Syringe prescription works synergistically with other approaches to provide people who inject drugs with legal access to sterile syringes.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- African Americans
- Female
- HIV Infections
- HIV Seropositivity
- Hepatitis
- Hepatitis, Viral, Human
- Humans
- Needle Sharing
- Needle-Exchange Programs
- Pharmacies
- Pharmacists
- Physicians
- Prescriptions, Drug
- Rhode Island
- Substance Abuse, Intravenous
- Substance-Related Disorders
- Syringes
- methods
Other ID:
UI: 102262065
From Meeting Abstracts