Hepatitis C and its risk management among drug injectors in London: renewing harm reduction in the context of uncertainty
- 8 April 2004
- Vol. 99 (5) , 621-633
- https://doi.org/10.1111/j.1360-0443.2004.00692.x
Abstract
Aim Recognizing the dearth of qualitative research on hepatitis C virus (HCV) infection associated with injecting drug use in the UK, this paper summarizes qualitative insights from a study exploring the social relations of HCV risk management among drug injectors in London.Method Adopting an inductive approach to data collection and analysis, 59 depth tape‐recorded qualitative interviews were undertaken in 2001 with drug injectors recruited via drug user networks.Results While access to injecting equipment was reportedly good, needle and syringe sharing continued in exceptional circumstances and in the context of ‘trust relationships’. Analyses of drug injectors’ accounts of variations of ‘I never share’ showed that this construction denoted less a descriptor of actual risk behaviour than presentation of perceived risk status. Paraphernalia sharing, including spoons and filters, was common. There was much confusion and uncertainty concerning HCV knowledge, including its medical and transmission risks. Injectors were aware of the provisionality and partiality of their HCV knowledge. Confusion also surrounded the meaning of HCV antibody test results, with some feeling that their positive diagnosis had been ‘trivialized’ by their experiences of HCV testing. Injectors tended to make sense of HCV risk in relation to HIV. With most viewing HCV prevalence as high and HCV transmission as an inevitable consequence of injecting, HCV risk was perceived as ubiquitous and unavoidable.Conclusions There is an urgent need to renew UK policies of harm reduction in order to support perceptions that HCV is avoidable and preventable.Keywords
This publication has 56 references indexed in Scilit:
- Anthropology and epidemiology on drugs: the challenges of cross-methodological and theoretical dialogueInternational Journal of Drug Policy, 2002
- Don't leave us this way: ethnography and injecting drug use in the age of AIDSInternational Journal of Drug Policy, 2002
- Predictors of hepatitis B and C infection in injecting drug users both in and out of drug treatmentAddiction, 2001
- Hepatitis C Virus Infection and Needle Exchange Use Among Young Injection Drug Users in San FranciscoHepatology, 2001
- Trends in HCV Prevalence Among Injecting Drug Users in Glasgow and Edinburgh During the Era of Needle/Syringe ExchangeScandinavian Journal of Infectious Diseases, 2001
- Hepatitis C Virus Infection: Prevalence, Risk Factors, and Prevention Opportunities among Young Injection Drug Users in Chicago, 1997–1999The Journal of Infectious Diseases, 2000
- Incidence and prevalence of hepatitis C among clients of a Brisbane methadone clinic: factors influencing hepatitis C serostatusAustralian and New Zealand Journal of Public Health, 1997
- Hepatitis C and policy implementation: ethics as a dialogic process for resource allocationAustralian and New Zealand Journal of Public Health, 1997
- Syringe-mediated drug sharing among injecting drug users: Patterns, social context and implications for transmission of blood-borne pathogensSocial Science & Medicine, 1996
- Aids and injecting drug use in the United Kingdom, 1987–1993: The policy response and the prevention of the epidemicSocial Science & Medicine, 1995