Impact of pharmacy-based syringe access on injection practices among injecting drug users in Minnesota, 1998 to 1999

In Minnesota, state legislation, enacted July 1998, provided for voluntary pharmacy safes of syringes/needles without a prescription for an accompanyi ng drug. The goal was to stem HIV transmission among injecting drug users ( IDUs) by providing greater access to sterile syringes. We used a pre/post e valuation design to investigate the impact of less restrictive syringe/poss ession laws on IDUs' HIV-related syringe practices. Independent cross-secti onal samples of IDUs were recruited from street sites and a correctional fa cility immediately before and 1 year after enactment of the laws. Of the 67 1 IDUs interviewed, 570 (270 prelegislation and 300 postlegislation) had in jected at least once in the 30 days before the interview. IDUs were more li kely to purchase syringes at pharmacies after enactment of the laws (odds r atio [OR], 2.66; 95% confidence interval [CI], 1.83-3.85), yet did not chan ge their behaviors regarding carrying unused syringes (OR, 0.90; 95% CT, 0. 63-1.28). After adjusting for speedball injection and criminal history, syr inge sharing decreased among IDUs (adjusted OR, 0.67; 95% CI, 0.45-1.00) ye t syringe reuse remained the same (adjusted OR, 0.67; 95% CI, 0.40-1.11). S afe disposal of syringes did not differ significantly across the sampling p eriods (adjusted OR, 1.32; 95% CI, 0.84-2.06). Increased access to pharmacy syringes offers a first step at reducing MV-related syringe practices but must be coupled with strong HIV prevention messages, drug treatment referra ls, and safe syringe disposal options.