báo cáo khoa học: Not sold here: limited access to legally available syringes at pharmacies in Tijuana, Mexico

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báo cáo khoa học: " Not sold here: limited access to legally available syringes at pharmacies in Tijuana, Mexico"Pollini et al. Harm Reduction Journal 2011, 8:13http://www.harmreductionjournal.com/content/8/1/13 RESEARCH Open AccessNot sold here: limited access to legally availablesyringes at pharmacies in Tijuana, MexicoRobin A Pollini1*, Perth C Rosen1, Manuel Gallardo2, Brenda Robles2, Kimberly C Brouwer1, Grace E Macalino3 andRemedios Lozada2 Abstract Background: Sterile syringe access is a critical component of HIV prevention programs. Although retail pharmacies provide convenient outlets for syringe access, injection drug users (IDUs) may encounter barriers to syringe purchase even where purchase without a prescription is legal. We sought to obtain an objective measure of syringe access in Tijuana, Mexico, where IDUs report being denied or overcharged for syringes at pharmacies. Methods: Trained “mystery shoppers” attempted to buy a 1 cc insulin syringe according to a predetermined script at all retail pharmacies in three Tijuana neighborhoods. The same pharmacies were surveyed by telephone regarding their syringe sales policies. Data on purchase attempts were analyzed using basic statistics to obtain an objective measure of syringe access and compared with data on stated sales policies to ascertain consistency. Results: Only 46 (28.4%) of 162 syringe purchase attempts were successful. Leading reasons for unsuccessful attempts were being told that the pharmacy didn’t sell syringes (35.3%), there were no syringes in stock (31.0%), or a prescription was required (20.7%). Of 136 pharmacies also surveyed by telephone, a majority (88.2%) reported selling syringes but only one-third (32.5%) had a successful mystery shopper purchase; the majority of unsuccessful purchases were attributed to being told the pharmacy didn’t sell syringes. There was similar discordance regarding prescription policies: 74 pharmacies said in the telephone survey that they did not require a prescription for syringes, yet 10 of these pharmacies asked the mystery shopper for a prescription. Conclusions: IDUs in Tijuana have limited access to syringes through retail pharmacies and policies and practices regarding syringe sales are inconsistent. Reasons for these restrictive and inconsistent practices must be identified and addressed to expand syringe access, reduce syringe sharing and prevent HIV transmission.Background (SEPs) and pharmacies. SEPs have proven effective in reducing syringe sharing [3], but the number of theseInjection drug users (IDUs) are at high risk of infection programs - and the overall number of syringes they dis-with HIV, hepatitis C (HCV) and other blood-borne tribute - is not sufficient to provide IDUs with a sterilepathogens transmitted by sharing syringes and otherinjection equipment. Globally, almost 20% of the world’s syringe for each injection. In Latin America, for example, only 5 of 20 countries are known to have implemented15.9 million IDUs are infected with HIV [1] and in some SEPs, which serve only approximately 2% of the region’sstudies HCV prevalence among IDUs is >90% [2]. IDUs [4]. Transmission of these pathogens can be prevented by Pharmacies can provide a more comprehensive and con-eliminating syringe sharing among IDUs. This requires venient source of syringes for IDUs, as they generallythat sterile syringes be available at appropriate times and exceed SEPs in number of locations and hours of operation.in sufficient quantities to supply a sterile syringe for eachinjection. In most settings, IDUs’ avenues for obtaining In some areas, however, pharmacy-based syringe access is hampered by laws requiring a prescription for purchase.sterile syringes are limited to syringe exchange p ...