Collaborating with Law Enforcement in HIV/AIDS Prevention: Officers' Attitudes on Syringe Access Programs in North Carolina

Background: North Carolina ranks 12^th highest in the country in terms of cumulative AIDS cases, with 28.5% attributable to injection drug use.(1) Similar to national trends, North Carolina minorities are disproportionately impacted by HIV/AIDS. African Americans comprise 22% of the state’s population, yet make up 67% of cumulative AIDS cases.(1, 2)  Despite overwhelming evidence that access to sterile syringes is an effective prevention strategy that can reduce the spread of HIV/AIDS and other diseases (3, 4), North Carolina does not permit syringes access programs (SAPs) to operate legally (5), and fewer than 5% of syringes are dispensed in the South.(6) Law enforcement practices that impede access to sterile syringes may contribute directly to higher disease burdens among African Americans. (8-10) Legalizing SAPs without legalizing possession of syringes may increase risk of arrest for SAP attendees, particularly among attendees of color.(11) This presentation offers results from a survey of the attitudes of law enforcement officers (LEOs) trained in an evidence-based approach to interact with people in mental health crisis known as Crisis Intervention Teams (CIT) regarding syringe decriminalization.(12)

Methods: Data were collected during an hour-long training for LEOs becoming CIT certified (N=348) during 2012-2013. The session provided an overview of HIV and other diseases and instructed LEOs on ways to reduce on-the-job transmission (13) as well as recent legal and policy changes regarding syringe decriminalization. A likert scale was used using four response categories that were dichotomized for analysis to query respondent’s regarding HIV injury risk perception and attitudes towards syringe decriminalization. Descriptive statistics were compiled for each question and assessed by race and gender. Statistically significant differences in attitudes by race or gender were analyzed using a chi-square test with an a priorisignificance level of 0.05.

Results: Although respondents overwhelmingly reported that they feared contracting HIV on the job, only thirteen respondents (3.8%) reported ever receiving a job-related needlestick injury. About 42% of respondents agreed that statewide decriminalization would promote drug use, 59% said that their impression of syringe decriminalization was generally positive, with nearly 60% agreeing that decriminalization would reduce HIV, be “good for the community” and “good for law enforcement.” Interestingly, both Black and female officers were statistically significantly less likely to report that they feared contracting HIV on the job, and more likely to agree that decriminalization would be “good for the community” and “good for law enforcement.”

Discussion: Although several initiatives have bundled LEO occupational safety training with syringe access information, few studies show baseline attitudes towards harm reduction programs.(13-16). Results suggest female and African American LEO had more tolerant attitudes towards syringe decriminalization and less fear of their HIV/AIDS as an occupational hazard; findings that have not been previously reported.  Although all participants were sworn LEOs, it is possible that job duties varied by race or sex in ways affected risk perception and attitudes. This could include knowing someone living with HIV/AIDS. The presentation highlights policy implications and social work collaboration with law enforcement.

References available in APA format.