Research

A national physician survey on prescribing syringes as an HIV prevention measure

GE Macalino¹ , D Dhawan Sachdev² , JD Rich³ , C Becker⁴ , LJ Tan⁵ , L Beletsky⁶ and S Burris⁷

¹  Arthur Ashe Institute for Urban Health, 450 Clarkson Ave Box 1232, Brooklyn, New York 11203, USA

²  Brown Medical School, Providence, Rhode Island 02912, USA

³  The Miriam Hospital, 164 Summit Avenue, Providence, Rhode Island 02906, USA

⁴  Brown University, Providence, Rhode Island 02912, USA

⁵  American Medical Association, 515 N State Street, Chicago, Illinois 60610, USA

⁶  Temple University School of Law, 1719 North Broad St Philadelphia, Pennsylvania 19122, USA

⁷  Temple University School of Law, 1719 North Broad St Philadelphia, Pennsylvania 19122, USA

author email corresponding author email

Substance Abuse Treatment, Prevention, and Policy 2009, 4:13doi:10.1186/1747-597X-4-13

Published:	8 June 2009

Abstract

Background

Access to sterile syringes is a proven means of reducing the transmission of human immunodeficiency virus (HIV), viral hepatitis, and bacterial infections among injection drug users. In many U.S. states and territories, drug paraphernalia and syringe prescription laws are barriers to syringe access for injection drug users (IDUs): pharmacists may be reluctant to sell syringes to suspected IDUs, and police may confiscate syringes or arrest IDUs who cannot demonstrate a "legitimate" medical need for the syringes they possess. These barriers can be addressed by physician prescription of syringes. This study evaluates physicians' willingness to prescribe syringes, using the theory of planned behavior to identify key behavioral influences.

Methods

We mailed a survey to a representative sample of physicians from the American Medical Association physician database. Non-responding physicians were then called, faxed, or re-sent the survey, up to four times.

Results

Twenty percent responded to the survey. Although less than 1 percent of respondents had ever prescribed syringes to a known injection drug user, more than 60% of respondents reported that they would be willing to do so. Physicians' willingness to prescribe syringes was best predicted by the belief that it was a feasible and effective intervention, but individual and peer attitudes were also significant.

Conclusion

This was the first nationwide survey of the physician willingness to prescribe syringes to IDUs. While the majority of respondents were willing to consider syringe prescription in their clinical practices, multiple challenges need to be addressed in order to improve physician knowledge and attitudes toward IDUs.