HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Grund, J P Articles by Adriaans, N F Search for Related Content PubMed PubMed Citation Articles by Grund, J P Articles by Adriaans, N F

Needle sharing in The Netherlands: an ethnographic analysis.

J P Grund, C D Kaplan and N F Adriaans

EUR Addiction Research Institute (IVO), Erasmus University Rotterdam, The Netherlands.

BACKGROUND. Needle sharing has been reported to be the main cause of the rapid spread of the human immunodeficiency virus (HIV) among injecting drug users. Risk behaviors such as needle sharing are, however, the end result of complicated interaction patterns in drug user networks, which have their specific rules and rituals, and larger social structures and official drug policy. METHODS. To study these interaction patterns we examined the drug administration rituals of heroin addicts in Rotterdam, The Netherlands. Intensive ethnographic descriptions were collected by participant observation. RESULTS. In less than 10% of the observed self-injections unsafe syringes were used. In 68% of the self-injections new, sterile syringes were used. Needle sharing as a planned sequence was not observed. Sharing was determined primarily by the availability of syringes, experience with the injecting ritual, and drug craving. In all observed needle-sharing events, subjects were aware of the risks involved and undertook efforts to clean the injection equipment. CONCLUSIONS. In contrast to psychological approaches aimed at reducing individual "risk behavior," these findings suggest that HIV prevention can be made more effective if active drug injectors are organized to help themselves and their peers prevent high-risk exchange situations.

This article has been cited by other articles:

				K. M. Blankenship and S. Koester Criminal Law, Policing Policy, and HIV Risk in Female Street Sex Workers and Injection Drug Users J. Law Med. Ethics, December 1, 2002; 30(4): 548 - 559. [PDF]

				M. W. Devries Recontextualizing Psychiatry: Toward Ecologically Valid Mental Health Research Transcultural Psychiatry, June 1, 1997; 34(2): 185 - 218. [Abstract] [PDF]

				F. Smyth and R. Thomas Preventative action and the diffusion of HIV/AIDS Progress in Human Geography, March 1, 1996; 20(1): 1 - 22. [PDF]