ASAP: Access to Syringes at Pharmacies for the Prevention of Bloodborne Infections among People who Inject Drugs

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Although interventions such as syringe service programs have attempted to address the need for sterile syringes to prevent blood borne infections (BBI) among people who inject drugs (PWID), the programs are often fragmented and therefore difficult to evaluate in terms of a “product” with potential for widespread dissemination and implementation in a sustainable manner. Further, these types of prevention efforts do not exist universally across the U.S., especially in the Southwestern region among largely minority populations. Access to Syringes at Pharmacies (ASAP) is a refinement of an evidence-based, pharmacy intervention to increase pharmacy-based sales of syringes to PWID in order to reduce BBI among them. The refinement integrates a motivational enhancement to reduce staff ambivalence about syringe sales to PWID, sampling improvements to assure that project pharmacies are likely serving PWID, and refinements to the intervention training content and delivery in three selected Arizona project counties of Mohave, Maricopa and Pima. Our development and refinement of ASAP relies on: 1) interviews with pharmacy staff of 6 pharmacies (2 for each county) that will assess feasibility, acceptance and likely adoption of the initial draft of the ASAP intervention, and 2) interviews and surveys among pharmacy staff of 3 pharmacies (1 from each county). ASAP’s adaptations and refinements will be guided by a highly iterative process between investigators and a community advisory board (CAB). Further, the Consolidated Framework for Implementation Research (CFIR) will guide feasibility assessment with a focus on selected CFIR elements across the domains of intervention characteristics, outer and inner setting, characteristics of individuals and process. The project will occur in two phases. The Year 1 formative phase will involve: 1) in-depth interviews with staff of 6 pharmacies to clarify intervention components, training and feasibility. Findings will inform the Year 2 iterative ASAP development and refinement phase between investigators and the CAB; including extensive feedback from pharmacy staff of 3 pharmacies following an ASAP beta test. Specific Aims are: Aim 1: To conduct the formative research among pharmacy staff required to develop and beta test the ASAP intervention materials (e.g., training manual, manual of operations, evaluation protocols). Aim 2: To determine the feasibility of the ASAP intervention relative to impact on pharmacy syringe- related sales and pharmacy interactions with PWID at time of syringe buy request.