Objective: To review the legal and regulatory barriers that restrict pharma
cy sales of syringes to injection drug users (IDUs) and to discuss how redu
cing these barriers can facilitate access to sterile syringes for IDUs and
improve HIV prevention.
Background: IDUs' access to sterile syringes from community pharmacies in t
he United States is limited by stale laws and regulations governing syringe
sales. Restricted availability of sterile syringes from pharmacies is a st
ructural barrier that greatly impedes HIV prevention for IDUs, who often sh
are and reuse syringes because they cannot obtain and possess sterile syrin
ges. These high-risk behaviors contribute to the transmission of HIV and ot
her blood-borne pathogens among IDUs, their sexual partners, and their chil
State experiences: In Connecticut, because of high HIV prevalence among IDU
s, restrictive syringe laws were changed. After the legal changes in Connec
ticut, both pharmacy sales of syringes in areas of high drug use and pur ch
ases of syringes in pharmacies (reported by IDUs) increased, while syringe
sharing (reported by IDUs) decreased. Maine and Minnesota have made similar
changes in laws.
Conclusions: Increasing access to sterile syringes through pharmacies requi
res the repeal or modification of legal barriers. Pharmacy sale of syringes
to IDUs is an inexpensive HIV prevention intervention with the potential t
o substantially reduce HIV transmission. Further studies are needed to docu
ment how changes to legal barriers can influence HIV prevention for IDUs. (
C) 2000 Lippincott Williams & Wilkins.