Syringe Purchase Program in Yolo County

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Practicum project for the MPH degree at the University of California Davis, School of Medicine. Here I conducted a policy assessment of the California Syringe Purchase Program in Yolo County. These findings were later requested by the state to help model a statewide policy assessment of the Syringe Exchange Program.

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Syringe Purchase Program in Yolo County

  1. 1. Compliance to the Syringe Purchase Program and Syringe Disposal Awareness Yolo County Pharmacies Ahmed Ibrahim Sheila Allen PhD, RN County of Yolo Health Department HIV/AIDS Program
  2. 2. Background <ul><li>Senate Bill 1159-Effective 2005-2010 </li></ul><ul><li>Permit to sell up to 10 syringes/needles without a prescription </li></ul><ul><li>Over eighteen years of age </li></ul><ul><li>Pharmacies-register in the Disease Prevention Demonstration Project. (DPDP) </li></ul><ul><li>AB 1305-Effective September 2008 </li></ul><ul><li>Illegal to dispose of needles, syringes or other sharps in municipal trash or sewage system. </li></ul><ul><li>Injection Drug Users are a high risk group for HIV and HCV infection </li></ul><ul><li>Sharing needles is a major risk factor for blood-borne infections </li></ul><ul><li>Syringe exchange programs and syringe purchase programs aim to provide sterile syringes and risk education to injection drug users. </li></ul>
  3. 3. Project Objectives All Pharmacies in Yolo County Maintained Participation Ended Participation Risk factors Access to Syringes/information Access to syringes Attitudes/Beliefs Syringe Disposal Resources Pharmacist Consumer
  4. 4. Results: Pharmacy Participation 1. 50% decrease in participation due mainly to pharmacy drop out. 2. Newly established pharmacies never contacted for participation
  5. 5. Results: Investigating Risk Factors Crude Odds Ratio Univariate Logistic Regression 0.266 0.25 Longs Pharmacies 0.691 1.6 Pharmacies in Davis 0.60 0.50 0.39 0.14 0.93 OR Employee-related 0.623 Change in management since recruitment 0.617 Non-branch pharmacies 0.466 Rite Aid Pharmacies By Franchise 0.0675 Pharmacies in Woodland 0.951 Pharmacies in West Sacramento By City P-value Risk Factor
  6. 6. Results: Attitudes and Beliefs of Non-participating Pharmacy on SB 1159 100% of all respondents agreed to resume participation if their specific concern was addressed.
  7. 7. Correlation suggests access of needles at pharmacies to IDU’s CRIME DATA TAKEN FROM THE UNITED STATES DEPARTMENT OF JUSTICE, BUREAU OF JUSTICE STATISTICS 0.0276 P-value (95% CI) 0.9456 R 2
  8. 8. Clients of Syringe Purchase Program Have little access to information.
  9. 9. Conclusions S trengths T hreats O pportunities W eaknesses Population size: Too small for meaningful stat analysis. No systematic method for investigating possible risk factors. Pharmacist attitudes are supportive Pharmacy concerns are addressable SB 1159 expires in 2010 Understaffing and budget cuts Syringe disposal remains a major concern 100% compliance Pilot study guiding future assessments
  10. 10. Acknowledgements County of Yolo Health Department Sheila Allen PhD, RN Jason Spitzer Thomas Stopka, MHS Sherif Ali, DVM, MPVM UC Davis School of Public Health/Veterinary Medicine Dr. Stephen McCurdy (Director) Dr. Christian Sandrock (Advisor) UC Davis Faculty Amber Carrere Colleagues MPH Class 2008 MPVM Class 2008 Epidemiology Graduate Group Comparative Pathology Group Nutrition Masters Group
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