S68 Supplement to the Journal of the American Pharmaceutical Association November/December 2002 Vol. 42, No. 6, Suppl. 2 RESEARCH Injection Drug Users Report Good Access to Pharmacy Sale of Syringes Wendy Reich, Wilson M. Compton, Joseph C. Horton, Linda B. Cottler, Renee M. Cunningham-Williams, Robert Booth, Merrill Singer, Carl Leukefeld, Joseph Fink, Tom J. Stopka, Karen Fortuin Corsi, and Michelle Staton Tindall Injection drug users (IDUs) are at risk for acquiring human immunodeficiency virus (HIV), hepatitis B virus, and hepatitis C virus through the sharing of contaminated syringes, water, cookers, cotton, and other injection equipment. 1–3 Pharmacies are an obvious source of sterile syringes for IDUs. 4–7 However, a number of barri- ers, including drug paraphernalia and syringe prescription laws, make access to syringes from pharmacies difficult for IDUs. 8,9 In addition, some pharmacists may have negative feelings about IDUs and be unwilling to have them as customers. They may also be unwilling to sell sterile syringes to IDUs because they worry about used syringes being unsafely disposed of in public areas. 1,10 Objectives To learn more about these issues, we conducted a series of phar- macist focus groups in urban and rural areas of four states, and the results of this study are reported elsewhere in this supplement. 1 We also addressed these issues from the perspective of the IDUs in a parallel series of focus groups conducted as part of the same study, funded by the National Institute on Drug Abuse, of the availabili- ty of syringes. This article presents results of the IDU focus groups Objective: To examine injection drug users (IDUs) opinions and behavior regarding purchase of sterile syringes from pharmacies. Design: Focus groups. Setting: Urban and rural sites in Colorado, Connecticut, Kentucky, and Missouri. Patients or Other Participants: Eight focus groups, with 4 to 15 IDU participants per group. Interventions: Transcripts of focus group discussions were evaluated for common themes by the authors and through the use of the software program NUD*IST. Main Outcome Measures: Knowledge of human immunodeficiency virus (HIV), pharmacy use, barriers to access from pharmacies, high-risk and risk-reducing behavior, and rural/urban difference. Results: Almost all participants knew the importance of using sterile syringes for disease preven- tion and reported buying syringes from pharmacies more than from any other source. Two IDUs believed pharmacists knew the syringes were being used for injecting drugs and perceived pharmacists’ sales of syringes to be an attempt to contribute to HIV prevention. Most IDUs reported that sterile syringes were relativity easy to buy from pharmacies, but most also reported barriers to access, such as hav- ing to buy in packs of 50 or 100, being made to sign a book, having to make up a story about being diabetic, or having the feeling that the pharmacists were demeaning them. While the majority of IDUs reported properly cleaning or not sharing syringes and safely dis- posing of them, others reported inadequate cleaning of syringes and instances of sharing syringes or of improper disposal. There were few differences in IDUs’ reported ability to buy syringes among states or between urban and rural sites, although the data suggest that IDUs could buy syringes more easily in the urban settings. Conclusion: For the most part, participants understood the need for sterile syringes in order to protect themselves from HIV, hepatitis B virus, and hepatitis C virus and saw pharmacies as the best source of ster- ile syringes. Although these data are not generalizable, they suggest that pharmacists can and do serve as HIV-prevention service providers in their communities. J Am Pharm Assoc. 2002;42(suppl 2):S68–72. Received August 27, 2002. Accepted for publication September 6, 2002. Wendy Reich, PhD, is research associate professor of anthropology in psychiatry; Department of Psychiatry, Washington University, St. Louis. Wilson M. Compton, MD, MPE, is director, Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, Bethesda, Md. At the time this research was done, Dr. Compton was associate professor, Washington University, St. Louis. Joseph C. Horton, MSW, is research associate; Linda B. Cottler, PhD, is professor of epidemiology; Renee M. Cunningham-Williams, PhD, MPE, is research assistant professor, Washington University, St. Louis. Robert Booth, PhD, is professor; Karen Fortuin Corsi, MPH, is project director, University of Colorado, Denver. Merrill Singer, PhD, is associate director and chief of research; Tom J. Stopka, MHS, is project director, Hispanic Health Council, Hartford, Conn. Carl Leukefeld, DSW, is professor of psy- chiatry and behavioral science; Joseph Fink, BS Pharm, JD, is vice pres- ident of research; Michelle Staton Tindell, MSW, is project director, University of Kentucky, Lexington. Correspondence: Wendy Reich, PhD, Washington University, School of Medicine, Department of Psychiatry, 660 South Euclid, Campus Box 8134. St. Louis, MO 63110. Fax: 314-747-6777. E-mail: wendyr@ twins.wustl.edu.