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  • Title: Risk reduction among injecting drug users: changes in the sharing of injecting equipment and in condom use.
    Author: Klee H, Faugier J, Hayes C, Morris J.
    Journal: AIDS Care; 1991; 3(1):63-73. PubMed ID: 1854816.
    Abstract:
    In an investigation of risk behaviour among injecting drug users in the North-West of England, information was obtained concerning the sharing of injecting equipment, respondent's sexual partners and the use of condoms. Between six and nine months after the initial contact, 169 respondents (56%) were contacted again. The emphasis in the second phase of the project was on changes, if any, in risk behaviour that had occurred in the intervening period. Significant reductions were found in sharing, mostly in the more indiscriminate use of others' injecting equipment. No reduction was observed in sharing between injecting partners and little in sharing between close friends. The number of sexual partners had decreased and the use of condoms, although it increased among those involved in temporary relationships, remained low. Impediments to further progress in risk reduction are discussed. 303 injecting drug users from North-West England were interviewed between May-December 1988 in a study of HIV-related risk behavior, and 169 were interviewed again 6-9 months later to assess changes in behavior. The area covered was Manchester, Liverpool, their suburbs, and nearby inland and coastal towns. The subjects ranged in age from 16-45; 35% were 25 years. 73% were male. In the 6 months prior, 62% had shared their injecting equipment with others, 44% had used others' equipment, 35% had casual sexual contact, and 75% never used condoms. At the second interview 19% had stopped using drugs, and 29 had stopped injecting only; 75% had not changed their treatment status. 87% reduced the frequency of using others' equipment; 78% reduced their frequency of sharing their equipment with others. Most to the decrease in sharing had occurred among casual strangers. A small, significant fall in number of sexual contacts was reported in contrast to persons who increased number of contacts. A majority preferred non-drug using sexual partners, and 68% had non-users as partners. The respondents reported an increase in condom use from 20 to 31%, especially among occasional drug users and non-users, and with casual partners. 26% had an HIV test between interviews, more often persons reporting sharing of injecting equipment. The problem of sharing drug equipment among couples and friends is a cause of concern. People tend to relax caution as the duration of the relationship lengthens. Condom use is difficult for drug users to negotiate, because their peers associate condoms with increased likelihood of HIV infection, and they perceive suggesting condoms as a risk of loss of a potential desired sexual partner. Similarly, drug users, often with strong needs for acceptance, have difficulty resisting the sharing of equipment among their peers.
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