Original Paper

AIDS and Behavior

, Volume 11, Issue 5, pp 652-662

Safe Syringe Disposal is Related to Safe Syringe Access among HIV-positive Injection Drug Users

  • Phillip O. CoffinAffiliated withCenter for Urban Epidemiologic Studies, New York Academy of Medicine Email author 
  • , Mary H. LatkaAffiliated withCenter for Urban Epidemiologic Studies, New York Academy of Medicine
  • , Carl LatkinAffiliated withJohns Hopkins Bloomberg School of Public Health
  • , Yingfeng WuAffiliated withCenter for Urban Epidemiologic Studies, New York Academy of Medicine
  • , David W. PurcellAffiliated withNational Center for HIV, STD, TB Prevention, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention
  • , Lisa MetschAffiliated withDepartment of Epidemiology and Public Health, Comprehensive Drug Research Center, University of Miami School of Medicine
  • , Cynthia GomezAffiliated withCenter for AIDS Prevention Studies, University of California, San Francisco
  • , Marc N. GourevitchAffiliated withDivision of General Internal Medicine, Department of Medicine, New York University School of Medicine
  • , INSPIRE Study Group

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We evaluated the effect of syringe acquisition on syringe disposal among HIV-positive injection drug users (IDUs) in Baltimore, New York City, and San Francisco (N = 680; mean age 42 years, 62% male, 59% African-American, 21% Hispanic, 12% White). Independent predictors of safe disposal were acquiring syringes through a safe source and ever visiting a syringe exchange program. Weaker predictors included living in San Francisco, living in the area longer, less frequent binge drinking, injecting with an HIV+ partner, peer norms supporting safe injection, and self-empowerment. Independent predictors of safe “handling”—both acquiring and disposing of syringes safely—also included being from New York and being older. HIV-positive IDUs who obtain syringes from a safe source are more likely to safely dispose; peer norms contribute to both acquisition and disposal. Interventions to improve disposal should include expanding sites of safe syringe acquisition while enhancing disposal messages, alternatives, and convenience.


Injection drug user HIV Hepatitis C Syringe exchange Syringe disposal