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Preventing HIV Transmission: The Role of Sterile Needles and Bleach
to eliminating important barriers to the availability of needles. However, their disposition to cooperate is at issue.
Various surveys of pharmacists and pharmacy owner-managers have been undertaken to assess their attitudes toward over-the-counter sales and pharmacy-based needle exchange programs. However, as noted by the University of California study (Lurie et al., 1993), a limited number of surveys has been conducted in the United States; to date, only one has been published. The New Orleans survey results reveal that a small portion of pharmacists (14.5 percent) indicated that they sold needles to anyone requesting them. The majority of respondents sold needles only to clients who had a valid medical prescription, even though Louisiana has no prescription law (Lawrence et al., 1991).
Other countries (the United Kingdom, France, Belgium, Australia, and Canada) have conducted surveys of pharmacists and pharmacy owner-managers (see Lurie et al., 1993). The results show similar concerns across countries with regard to selling needles over the counter and participating in a pharmacy-based needle exchange program. The main concerns include potential negative effects on business revenues and the quality of overall services provided to other customers. For example, Glanz et al. (1989) reported that pharmacies believed that the presence of injection drug users would adversely affect business (68 percent) and would lead to an increase in theft (63 percent). Similar concerns were raised in surveys in other countries (e.g., in Australia, Tsai et al., 1988). An additional issue raised by the survey respondents relates to the disposal of needles returned to pharmacies. Survey results also indicate that disposal of used needles represents a disincentive for pharmacies to participate in pharmacy-based needle exchange programs.
These concerns were also voiced by two professional pharmaceutical industry representatives at the panel's workshop on community views. They represented the National Association of Chain Drug Stores (pharmacy retailers) and the American Pharmaceutical Association (professional pharmacists).
The representative of pharmacy retailers indicated that, although the retailers support the establishment of needle exchange and bleach distribution programs, their association does not feel that pharmacies are the most appropriate sites. Areas of concern include:
quality of health care services (i.e., providing advice, education, counseling about medications) to customers other than injection drug users may be adversely affected;