OTC Syringe Sales to Prevent HIV in Underserved Areas of Inland California

销售非处方药注射器以预防加利福尼亚州内陆服务欠缺地区的艾滋病毒

基本信息

批准号：
8601068
负责人：
Robin A Pollini
金额：
$ 67.31万
依托单位：
PACIFIC INSTITUTE FOR RES AND EVALUATION
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-01-01 至 2016-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8601068
关键词：
AIDS prevention Accounting Address Agriculture Area California Canada Characteristics Cities Cocaine Communities Complement County Data Environment Epidemic Geographic Locations HIV HIV Infections HIV risk Heroin Individual Injecting drug user Injection of therapeutic agent International Interview Knowledge Latino Law Enforcement Laws Methamphetamine Methods Mexican Mexico Modeling Natural experiment Needle Sharing Needle-Exchange Programs Pharmaceutical Preparations Pharmacy facility Phase Play Population Prevention Research Prevention strategy Preventive Intervention Production Research Risk Behaviors Role Route Rural Sales Statutes and Laws Sterility Surveys Syringes United States base design drug market experience informant injection drug use innovation metropolitan multidisciplinary prevent programs public health relevance social success tool trafficking transmission process uptake urban area

项目摘要

DESCRIPTION (provided by applicant): This study will capitalize on the opportunity for a "natural experiment" in HIV prevention to assess the implementation of a new syringe access law, Senate Bill 41 (SB41), in the inland counties of California's Central Valley. Injection drug use rates in the Central Valley's southern counties are among the highest in the U.S. and contribute substantially to the region's HIV epidemic. SB41, which went into effect on January 1, 2012, allows pharmacies to sell up to 30 syringes without a prescription. Although the law has the potential to greatly expand syringe access in inland California's predominantly rural and Latino counties, which have thus far been greatly underserved by other syringe access programs, syringe sales under the law are voluntary and it is unclear to what extent pharmacies will participate. Our study will use an innovative mixed methods approach to (1) assess pharmacy implementation of this new over-the counter (OTC) syringe law, (2) characterize utilization of OTC syringe sales by injection drug users (IDUs) under the law, and 3) examine structural factors associated with both pharmacy implementation and IDU utilization. The study will be conducted in two counties, Fresno and Kern, using a three-phase approach to address factors at all three levels of the HIV "risk environment." In Phase I, we will conduct a syringe purchase trial (N=298), a brief pharmacy survey (N=596), and key informant interviews (N=32) to assess pharmacies' implementation of the law and characterize related barriers and facilitators. In Phase II, we will conduct an IDU survey (N=550) to understand IDU uptake of OTC syringe purchase under the law and identify related barriers and facilitators. In Phase III, we will conduct geospatial/contextual modeling to complement findings from Phases I & II and elucidate structural factors that influence SB41's impact. At the conclusion of our study, we will have generated a comprehensive understanding of the factors that facilitate and impede SB41's success as an HIV prevention tool. This information will assist the communities of inland California in developing multi-level strategies to optimize OTC syringe sales, reduce syringe sharing, and prevent HIV transmission among IDUs.

描述（由申请人提供）：本研究将利用预防艾滋病毒的“自然实验”的机会，以评估在加利福尼亚州中部山谷内陆县的新注射器访问法第41（SB41）的实施。中央山谷南部县的注射药物使用率是美国最高的，并为该地区的艾滋病毒流行做出了重大贡献。 SB41于2012年1月1日生效，允许药房在没有处方的情况下出售多达30个注射器。尽管该法律有可能大大扩大加利福尼亚州内陆地区主要是农村和拉丁美洲裔县的注射器访问权限，但迄今为止，这些县对其他注射器访问计划的服务非常不足，但根据法律规定的注射器销售是自愿的，尚不清楚药房将在多大程度上参与。我们的研究将使用一种创新的混合方法方法来（1）评估该新的柜台（OTC）注射器法的药房实施，（2）表征根据法律注射吸毒者（IDU）对OTC注射器销售的利用（法律），以及3）检查与药房实施和IDU实施和IDU使用相关的结构因素。这项研究将在两个县弗雷斯诺和克恩进行，使用三相方法来解决HIV“风险环境”的所有三个级别的因素。在第一阶段，我们将进行注射器采购试验（n = 298），简短的药房调查（n = 596）和主要的线人访谈（n = 32），以评估药房对法律的实施并表征相关的障碍和辅助因子。在第二阶段，我们将进行IDU调查（n = 550），以了解法律规定的OTC注射器购买，并确定相关的障碍和协助者。在第三阶段，我们将进行地理空间/上下文建模，以补充I＆II阶段的发现，并阐明影响SB41影响的结构因素。在我们的研究结束时，我们将对促进和阻碍SB41作为HIV预防工具的成功的因素产生全面的理解。该信息将帮助加利福尼亚州内陆社区制定多层策略，以优化OTC注射器销售，减少注射器共享并防止IDU之间的HIV传播。