HIV Risk Behaviors Associated with the Injection Process: Multiperson Use of Drug Injection Equipment and Paraphernalia in Injection Drug User Networks
1998, Vol. 33, No. 12
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Pages 2403-2423
Richard H. Needle1†, Susan Coyle1, Helen Cesari1, Robert Trotter2, Michael Clatts3, Stephen Koester4, Laurie Price2, Eleanor McLellan2, Ann Finlinson5, Ricky N. Bluthenthal6, Todd Pierce†, Jay Johnson7, T. Stephen Jones8 and Mark Williams9
1National Institute on Drug Abuse, Rockville, Maryland, USA
2Northern Arizona University, Flagstaff, Arizona, USA
3National Development and Research Institutes, New York, New York, USA
4University of Colorado at Denver, Denver, Colorado, USA
5ASSMCA/Research Institute, San Francisco, CaliforniaUSA
6University of California at San Francisco, San Francisco, CaliforniaUSA
7Mental Health and Mental Retardation Authority of Harris, County, Texas, USA
8Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA
9NOVA Research Company
This study examines drug acquisition and multiperson use of paraphernalia, drugs, and needles/syringes. Ethnographers observed 54 injection episodes in which IDUs were linked by HIV risk behaviors, and developed a typology of higher-risk, lower-risk, and nonsharing-risk networks. Multiperson use of injection paraphernalia or drug solution occurred in most injection events (94%). Serial use of syringes/needles occurred infrequently (14%) relative to “backloading” (37%) and reuse of paraphernalia (cookers 84%, cotton 77%, water 77%). Higher-risk injection networks were characterized by larger size and pooling of resources for drugs. Prevention messages must include avoiding reuse of injection paraphernalia and transfer of drug solution.
