Injection drug use is a major risk factor in acquiring or transmitting blood-borne infections. Injection drug use accounts for the majority of Hepatitis C virus (HCV) infections and for 12 % of new Human Immunodeficiency Virus (HIV) infections in the United States. One of the most common ways blood-borne pathogens are transmitted is through unsafe injection practices, which can include syringe-sharing and multi-syringe use. For this reason it is important that sterile syringe use be limited to one-time use for each injection. One strategy to provide access to sterile syringes is through pharmacies. Studies have shown that IDUs permitted to purchase syringes from pharmacies are less likely to have HIV. There is no uniform national policy in the U.S. for sterile syringe access and disposal. In 2005, California Senate Bill 1159 was passed and allowed for syringes to be sold in a pharmacy without a prescription. San Francisco adopted the Senate Bill 1159 in 2005, whereas San Diego did not. Data from the Study to Assess Hepatitis C Risks (STAHR), a cross-sectional study conducted by the University of California, San Diego, was used for this study. From May 2009 to July 2010, IDUs currently living in San Diego County, between the ages of 18- 40 were recruited. Five hundred sixty-six eligible individuals were enrolled in the study. Data from the study UFO, a prospective cohort study conducted by the University of California, San Francisco, was also used for this study. From January 2006 to February 2011, IDUs currently living in San Francisco, 30 years or younger and HCV negative were enrolled in the study. Using data from STAHR and UFO, the objectives of this study are to (1) estimate the proportion of IDUs who are obtaining syringes from pharmacies in San Francisco versus San Diego, California; and (2) identify socio-demographic characteristics, injection practices and other behaviors that could be related to the selection of IDUs primary syringe source. After adjusting for all other covariates, location, age, race/ethnicity, income from stealing, using drugs other than heroin were significantly associated with pharmacy syringe purchases in the past three months (p<.05). The information that is gained from this study could help researchers, lawmakers and public health advocates understand the importance of investing and implementing laws regarding safe syringe acquisition from pharmacies.