Prescription Syringe Program Helps IV Drug Users Seek Treatment, Reduce Risk of HIV Transmission, Study Says
Prescriptions for sterile syringes serve as an "effective and acceptable tool among injection drug users to enhance [HIV/AIDS] compliance and preventative measures," including HIV testing and regular physicians visits, according to a preliminary report published in the May issue of the American Journal of Public Health. The pilot study, called the Rhode Island Blood Borne Pathogen Harm Reduction Program, was conducted in Rhode Island because about 50% of the state's AIDS cases are related to intravenous drug use, and the state enforces "very stringent laws on syringe possession." The pilot study included 323 participants, of whom 33% were female, 47% were homeless and 41% were non-white. The average age of participants was 41. At the point of enrollment, 39% of participants had "regular contact" with a physician, 40% had health insurance and 34% were in "some form of drug treatment." Physicians in the program offered syringes by prescription to participants to "prevent the transmission of HIV and other blood-borne pathogens." Physicians were also required to "keep detailed documentation of patient care, assist patients in the safe disposal of used syringes and conduct follow-up evaluations." Preliminary results from the pilot program "suggest that participant risk behavior is reduced and involvement in medical and substance abuse treatment is increased as a result of syringe prescription."
The prescription syringe program may also help foster intravenous drug users' "trust" in the medical community by facilitating "patient-physician interactions," according to the study. Dr. Josiah Rich, the study's lead investigator at Brown University's Miriam Hospital, said that the program "provides a safe, culturally sensitive, non-threatening way to reach a population in desperate need of treatment and support services." He added, "Not only is syringe prescription a feasible method for preventing HIV, but we also witnessed a transformation in the majority of patients in that they actually became willing and active participants in their own health care, from vaccination to drug abuse counseling to HIV and STD testing" (amfAR release, 4/30).
Dr. Mathilde Krim, chair of amfAR, which sponsored the study, said that the "findings are encouraging, ... especially in light of the need for more attention to the issue of needle sharing, which is accountable for many HIV cases." Rich said he hopes that the study will "catch the eye" of Massachusetts officials, where residents must have a prescription for syringes in order to purchase and possess the devices. Although the purchase of non-prescription syringes from a pharmacist is legal in Rhode Island, the practice is still illegal in Massachusetts and Vermont (Freyer, Providence Journal, 5/7). The study was funded by the American Foundation for AIDS Research, the Open Society Institute, the Center for Substance Abuse Treatment and Mental Health Services Administration and the Substance Abuse Policy Research Program of the Robert Wood Johnson Foundation (amfAR release, 4/30). To view the preliminary report, click here. Note: You must have Adobe Acrobat Reader to view the report. For more information about intravenous drug use and HIV/AIDS, please visit the CDC's Web page, http://www.cdc.gov/idu/.