International Journal of Drug Policy 14 (2003) 381–387 Injection drug users’ use of pharmacies for purchasing needles in Anchorage, Alaska Dennis G. Fisher a,* , Andrea M. Fenaughty b , Henry H. Cagle c , Grace L. Reynolds a a Centre for Behavioural Research and Services, California State University Long Beach, 1090 Atlantic Avenue, Long Beach, CA 90813, USA b Alaska Department of Health and Social Services, Data and Evaluation Unit, 3601 C Street #760, Anchorage, AK 99508, USA c Viral Hepatitis Program, Alaska Native Medical Centre, ANC-HEP, 4315 Diplomacy Drive, Anchorage, AK 99508, USA Received 1 December 2002; received in revised form 15 March 2003; accepted 21 July 2003 Abstract Objectives: Sterile needle and syringe (NS) access may play a significant role in the reduction of disease transmission. This study describes various characteristics of injection drug users’ (IDUs) procurement of NS at pharmacies. Methods: IDUs were recruited as part of a two-arm clinical trial with one arm being taught how to purchase NS at pharmacies and the other arm being able to exchange NS at a needle exchange. Data were analysed using descriptive statistics (chi-square and binomial tests for categorical data, t-tests, ANOVA, correlation and Wilcoxon rank sums for interval-level data) and run using SAS [SAS/STAT User’s Guide, Version 6, 4th ed., vols. 1 and 2, SAS Institute Inc., Cary, NC]. Results: IDUs were able to purchase NS at most Anchorage pharmacies. More IDUs randomised to a syringe exchange programme (SEP) arm of a clinical trial obtained NS from known sterile sources as compared to those IDUs randomised to the pharmacy sales arm. Conclusions: Communities seeking to maximise the proportion of IDUs who obtain sterile NS need to have both legal pharmacy sales and SEPs. © 2003 Elsevier B.V. All rights reserved. Keywords: Needle exchange; Pharmacy sales; Clinical trial Introduction The major risk factor for the transmission of HIV, Hep- atitis B Virus (HBV) and Hepatitis C Virus (HCV) among injection drug users (IDUs) is multi-person reuse of nee- dles and syringes (NS) (Friedland et al., 1985). Therefore, a major goal of public health intervention is to reduce NS sharing. NS availability may reduce mean needle circula- tion time, which has been shown to be associated with re- duced HIV prevalence in syringes in circulation (Kaplan, Khoshnood, & Heimer, 1994). This study reports on the in- vestigation of several issues related to syringe source for IDUs: racial differences in pharmacy purchase, factors as- sociated with pharmacy purchase success, whether financial cost is an important barrier to pharmacy purchase, and the effect of the availability of syringe exchange programmes (SEPs) on sterile syringe supply. * Corresponding author. Tel.: +1-562-495-2330; fax: +1-562-983-1421. E-mail address: dfisher@csulb.edu (D.G. Fisher). One example of a legal Pharmacy Sales condition is the Expanded Syringe Access Demonstration Program in New York City (Des Jarlais, McKnight, & Friedmann, 2002). This programme found that a large majority of those who at- tempted to purchase at pharmacies were successful. A report from Hartford, CT, also found that pharmacies are impor- tant sources of sterile syringes for IDUs (Singer, Baer, Scott, Horowitz, & Weinstein, 1998). Pharmacy sales in Minnesota became legal in July 1998. An evaluation of this legal change found that IDUs were more likely to purchase syringes at pharmacies after the law changed (Cotten-Oldenburg, Carr, DeBoer, Collison, & Novotny, 2001). Pharmacy sales of NS are not legal in all locations in the USA, neither are SEPs. Comerford et al. assessed attitudes of IDUs toward both SEP and pharmacy sales of NS, both of which are illegal in Florida (Comerford, Chitwood, McKay, Anderson, & Page, 1990). They found that 85% of 275 in- terviewed IDUs approved of needle exchange and 77% ap- proved of pharmacy sales. It is interesting that significantly fewer (69%) of those in favour of SEPs reported that they would use such services, compared to those in favour of 0955-3959/$ – see front matter © 2003 Elsevier B.V. All rights reserved. doi:10.1016/S0955-3959(03)00138-5