Syringe prescriptions written by physicians are a feasible way to increase the access of injection drug users to sterile syringes for HIV prevention, according to a Brown-led pilot study. Not only does a physician syringe prescription program provide injection drug users with links to medical care, substance abuse treatment and social services, the study suggests that it actually cuts risky behaviors and increases participation in medical and substance abuse treatment.
The findings come from a study of 323 individuals in Rhode Island, published in the May issue of the American Journal of Public Health. The American Foundation for AIDS Research (amFAR) funded the effort.
"This pilot study represents the first attempt to implement and evaluate syringe prescription on a programmatic basis," said Mathilde Krim, M.D., amfAR’s founding chair and chairman of the board. "The preliminary 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."
Previously, only a few physicians in rare situations, and never on a programmatic basis, have tried the strategy of prescribing syringes to injection drug users.
Injection drug use is a leading cause of HIV transmission, accounting for more than one-third of all adult AIDS cases in the United States. Rhode Island was selected as a study site because as many as 50 percent of its AIDS cases are related to injection drug use. Syringe prescription is legal in Rhode Island, but the state enforces very stringent laws on syringe possession.
"The syringe prescription program provides a safe, culturally-sensitive, non-threatening way to reach a population in desperate need of treatment and support services," said lead investigator Josiah Rich, M.D., associate professor of medicine. "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 sexually transmitted disease testing."
Rich and colleagues conducted the study with the buy-in of local physicians and health organizations. Given the illicit nature of drug use, injection drug users have traditionally regarded the medical community with fear and mistrust, the researchers said.