and AIDS preventive interventions is a better understanding of local community concerns.
More systematic research is needed on other ethnic groups who are known to be at high risk of infection (e.g., Puerto Ricans in New York City). This panel recognized its own limitations in attempting to address the issues and concerns of the multitude of communities that are summarized simply as Hispanic/Latino. More detailed investigation and response are needed.
Although some pharmacists, law enforcement officers, and treatment service providers have been supportive of needle exchange programs, others have expressed concerns and reservations about their potential role in making sterile injection equipment more readily available to injection drug users. A better understanding of the beliefs, attitudes, values, and motivational factors that influence these reservations needs to be developed through both qualitative and quantitative research efforts.
Within the context of deregulation of pharmacy sales and possession of needles, important issues warrant further research. For example, the practice of sharing needles and syringes continues in industrialized countries other than the United States. Some of these countries have needle exchange programs and no paraphernalia or prescription laws limiting the availability of sterile injection equipment. These circumstances lead the panel to suggest that:
Researchers need to identify the causal agents involved in sharing after legal constraints are removed. Ethnographic research should identify why needles and syringes continue to be shared when community availability is no longer a constraint (see Chapter 5, time of injection versus community availability issues).
In terms of the deregulation of syringe sale and possession (allowing injection drug users to purchase syringes in pharmacies), one important concern that requires immediate attention is that of developing efficient disposal methods for used needles and syringes. Pharmacies, with numerous locations and hours of operation, are convenient and accessible for obtaining syringes. However, the issue of appropriate needle and syringe disposal needs further consideration and planning.