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I could take the judgment if you could just provide the service: non-prescription syringe purchase experience at Arizona pharmacies, 2018

BACKGROUND: Community pharmacies are important for health access by rural populations and those who do not have optimum access to the health system, because they provide myriad health services and are found in most communities. This includes the sale of non-prescription syringes, a practice that is...

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Autores principales: Meyerson, Beth E., Lawrence, Carrie A., Cope, Summer Dawn, Levin, Steven, Thomas, Christopher, Eldridge, Lori Ann, Coles, Haley B., Vadiei, Nina, Kennedy, Amy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751644/
https://www.ncbi.nlm.nih.gov/pubmed/31533730
http://dx.doi.org/10.1186/s12954-019-0327-1
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author Meyerson, Beth E.
Lawrence, Carrie A.
Cope, Summer Dawn
Levin, Steven
Thomas, Christopher
Eldridge, Lori Ann
Coles, Haley B.
Vadiei, Nina
Kennedy, Amy
author_facet Meyerson, Beth E.
Lawrence, Carrie A.
Cope, Summer Dawn
Levin, Steven
Thomas, Christopher
Eldridge, Lori Ann
Coles, Haley B.
Vadiei, Nina
Kennedy, Amy
author_sort Meyerson, Beth E.
collection PubMed
description BACKGROUND: Community pharmacies are important for health access by rural populations and those who do not have optimum access to the health system, because they provide myriad health services and are found in most communities. This includes the sale of non-prescription syringes, a practice that is legal in the USA in all but two states. However, people who inject drugs (PWID) face significant barriers accessing sterile syringes, particularly in states without laws allowing syringe services programming. To our knowledge, no recent studies of pharmacy-based syringe purchase experience have been conducted in communities that are both rural and urban, and none in the Southwestern US. This study seeks to understand the experience of retail pharmacy syringe purchase in Arizona by PWID. METHODS: An interview study was conducted between August and December 2018 with 37 people living in 3 rural and 2 urban Arizona counties who identified as current or former users of injection drugs. Coding was both a priori and emergent, focusing on syringe access through pharmacies, pharmacy experiences generally, experiences of stigma, and recommendations for harm reduction services delivered by pharmacies. RESULTS: All participants reported being refused syringe purchase at pharmacies. Six themes emerged about syringe purchase: (1) experience of stigma and judgment by pharmacy staff, (2) feelings of internalized stigma, (3) inconsistent sales outcomes at the same pharmacy or pharmacy chain, (4) pharmacies as last resort for syringes, (5) fear of arrest for syringe possession, and (6) health risks resulting from syringe refusal. CONCLUSIONS: Non-prescription syringe sales in community pharmacies are a missed opportunity to improve the health of PWID by reducing syringe sharing and reuse. Yet, current pharmacy syringe sales refusal and stigmatization by staff suggest that pharmacy-level interventions will be necessary to impact pharmacy practice. Lack of access to sterile syringes reinforces health risk behaviors among PWID. Retail syringe sales at pharmacies remain an important, yet barrier-laden, element of a comprehensive public health response to reduce HIV and hepatitis C among PWID. Future studies should test multilevel evidence-based interventions to decrease staff discrimination and stigma and increase syringe sales.
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spelling pubmed-67516442019-09-23 I could take the judgment if you could just provide the service: non-prescription syringe purchase experience at Arizona pharmacies, 2018 Meyerson, Beth E. Lawrence, Carrie A. Cope, Summer Dawn Levin, Steven Thomas, Christopher Eldridge, Lori Ann Coles, Haley B. Vadiei, Nina Kennedy, Amy Harm Reduct J Research BACKGROUND: Community pharmacies are important for health access by rural populations and those who do not have optimum access to the health system, because they provide myriad health services and are found in most communities. This includes the sale of non-prescription syringes, a practice that is legal in the USA in all but two states. However, people who inject drugs (PWID) face significant barriers accessing sterile syringes, particularly in states without laws allowing syringe services programming. To our knowledge, no recent studies of pharmacy-based syringe purchase experience have been conducted in communities that are both rural and urban, and none in the Southwestern US. This study seeks to understand the experience of retail pharmacy syringe purchase in Arizona by PWID. METHODS: An interview study was conducted between August and December 2018 with 37 people living in 3 rural and 2 urban Arizona counties who identified as current or former users of injection drugs. Coding was both a priori and emergent, focusing on syringe access through pharmacies, pharmacy experiences generally, experiences of stigma, and recommendations for harm reduction services delivered by pharmacies. RESULTS: All participants reported being refused syringe purchase at pharmacies. Six themes emerged about syringe purchase: (1) experience of stigma and judgment by pharmacy staff, (2) feelings of internalized stigma, (3) inconsistent sales outcomes at the same pharmacy or pharmacy chain, (4) pharmacies as last resort for syringes, (5) fear of arrest for syringe possession, and (6) health risks resulting from syringe refusal. CONCLUSIONS: Non-prescription syringe sales in community pharmacies are a missed opportunity to improve the health of PWID by reducing syringe sharing and reuse. Yet, current pharmacy syringe sales refusal and stigmatization by staff suggest that pharmacy-level interventions will be necessary to impact pharmacy practice. Lack of access to sterile syringes reinforces health risk behaviors among PWID. Retail syringe sales at pharmacies remain an important, yet barrier-laden, element of a comprehensive public health response to reduce HIV and hepatitis C among PWID. Future studies should test multilevel evidence-based interventions to decrease staff discrimination and stigma and increase syringe sales. BioMed Central 2019-09-18 /pmc/articles/PMC6751644/ /pubmed/31533730 http://dx.doi.org/10.1186/s12954-019-0327-1 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Meyerson, Beth E.
Lawrence, Carrie A.
Cope, Summer Dawn
Levin, Steven
Thomas, Christopher
Eldridge, Lori Ann
Coles, Haley B.
Vadiei, Nina
Kennedy, Amy
I could take the judgment if you could just provide the service: non-prescription syringe purchase experience at Arizona pharmacies, 2018
title I could take the judgment if you could just provide the service: non-prescription syringe purchase experience at Arizona pharmacies, 2018
title_full I could take the judgment if you could just provide the service: non-prescription syringe purchase experience at Arizona pharmacies, 2018
title_fullStr I could take the judgment if you could just provide the service: non-prescription syringe purchase experience at Arizona pharmacies, 2018
title_full_unstemmed I could take the judgment if you could just provide the service: non-prescription syringe purchase experience at Arizona pharmacies, 2018
title_short I could take the judgment if you could just provide the service: non-prescription syringe purchase experience at Arizona pharmacies, 2018
title_sort i could take the judgment if you could just provide the service: non-prescription syringe purchase experience at arizona pharmacies, 2018
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751644/
https://www.ncbi.nlm.nih.gov/pubmed/31533730
http://dx.doi.org/10.1186/s12954-019-0327-1
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