Table 1 Reported experiences buying or attempting to buy syringes at Arizona pharmacies, 2018 (N = 37)

Experience of stigma and judgment from pharmacy staff

If you are going in there trying to get syringes, be prepared to not be treated great. ‘Cause all of a sudden they are gonna look at you like, “Oh, that’s what you are here for?” You do not know me, I could very well be diabetic, I suppose. They instantly change their whole demeanor. Not very comfortable at all. (#4, Kingman)

Feelings of internalized stigma

It would be like someone like me, heavily tattooed, transgender, walking into a Catholic Church on Sunday. You know what I mean? … That’s the only way I can really describe it, yeah. And with a pentagram shirt on … ..So, that’s how I feel, to walk into any pharmacy. (#37, Sierra Vista)

Inconsistent sales outcomes at the same pharmacy or pharmacy chain

There’s been some places where I’ve gone to the pharmacy to get needles and was able to do it without any problem, without them looking down on you or questioning why you are getting it, stuff like that. Then, there’s other times when you (return to the pharmacy and) can just tell that they are automatically assuming what you are going to use it for and you can see that they are prejudiced behind it … .. (They do not always sell to you); it’s kind of 50/50. (#26, Tucson)

Pharmacies as last resort for sterile syringes

It’s ... some of them are alright, some of them they look at you like, you know, you are a junkie, we ain’t gonna sell you these syringes because you are probably gonna shoot drugs up with it, so we are not gonna sell you them because apparently we are the only pharmacy around here that carries syringes, or we are the only place you are ever gonna get a syringe from. But, what they do not know is that you usually have a syringe you have used probably 20 times in your pocket, it’s all barbed up, and if you do not get a needle from them, you are gonna just use that one.…. or share a needle. (#31, Phoenix)

Fear of arrest for syringe possession

Well I know that it’s illegal to distribute a syringe to someone knowing that they are going to use drugs with it. Like, the person who involved me with syringe access told me it’s a class VI felony, which I think is the lowest degree of felony. I think Arizona has “your body is a container” laws, too. And you could probably be charged with paraphernalia or possession or whatever. (#10, Prescott)

Health risks resulting from syringe refusal

Oh, they would just turn me away and ask for some kind of documentation for diabetes or a prescription or something. And then that’s when most people will be afraid to go to try to get some and then they just go use whatever. (#11, Phoenix)