Theme: Social Science & Policy Research Year: 2016
BLOOD BORNE VIRUS RISK BEHAVIOURS AMONG PEOPLE WHO INJECT
DRUGS IN THE UK: A QUALITATIVE EXPLORATION
Swan D
1
, Shaw A
2
, Towers S
3
, Mdege N
4
, Craine N
5
, Widyaratna K
1
, Munro A
2
,
Hughes L
6
, Strang J
1
, Taylor A
2
, Gilchrist G
1
1 National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience,
King’s College London, UK
2 School of Media, Culture & Society, University of the West of Scotland, UK
3 Betsi Cadwaladr University Health Board, NHS Wales, UK
4 Department of Health Sciences, Faculty of Science, University of York, UK
5 Microbiology Department, Public Health Wales, UK
6 School of Human and Health Sciences, University of Hudderfield, UK
Background: In the UK, 33%-56% of people who inject drugs (PWID) have Hepatitis
C. HIV (0-1%) and Hepatitis B (6-18%) rates are lower. As part of a larger study to
develop and feasibility test an evidence-based psychosocial intervention to prevent
blood borne virus (BBV) infection among PWID in the UK, a sub-study was
conducted exploring the influences on injection- and sexual- risk behaviour among
PWID and the type of psychosocial interventions they would find useful.
Methods: Design: Qualitative interview study Setting: Sexual health services,
needle exchanges, drug treatment/harm reduction services and homeless hostels in
London, Yorkshire, Glasgow and North Wales. Participants: Convenience sample
of 60 ‘current injectors’ purposively sampled based on gender, length of time
injecting, and drugs injected. Measurements: In-depth interviews analysed using
Framework Analysis.
Results: Individual, situational, and structural factors influenced BBV risks.
Participants usually ascribed risk behaviour to the pressures of withdrawal, craving
and intoxication. Lack of knowledge, inexperience injecting, and poor vascular
access also promoted unsafe practices. Interpersonal relationships based on trust,
intimacy and/or dominance, and group norms and dynamics, also influenced risk.
Unstable housing and sex work diminished participants’ agency to manage risk.
Opiate substitution treatment, stable housing, and a BBV diagnosis were some of the
factors promoting behaviour change. Participants also pointed to the importance of
access to clean injecting equipment and condoms.
Conclusions: Individual, situational and structural factors drive vulnerability to BBV
infection among PWID and multi-faceted interventions are necessary.
Disclosure of Interest Statement: The authors declare that they have no conflicts
of interest.