ABSTRACT
There is no danger o f H I V infection from merely consuming il l icit drugs. It is the associated behaviour, the way in which they are administered, that distinguishes certain drug users from others in terms o f risk o f H I V infection. There are a variety o f reasons why individuals choose to inject drugs, and these w i l l be explored in this chapter. Even so, injecting w i th sterile needles and syringes is not in itself a high risk behaviour. It is the use o f unsterile injecting equipment and the sharing o f needles w i th others who may themselves have come into contact w i th someone w i th H I V infection, that constitutes high risk behaviour. It is because o f this potential that those who inject drugs have been singled out for particular concern, not least in terms o f the emphasis o f the U K government's recent media campaign and the decision to introduce a number o f pilot needle-exchange schemes. A l l this has, to a certain extent, turned the drugs field on its head. Some workers, dedicated to coaching their clients to abstinence, have had to rethink the paradigms wi th in which they operate and to incorporate notions o f harm minimization and risk reduction. Similarly, some drug clinics have had to swallow hard and prescribe oral methadone to injecting drug users who they suspect are en route to the needle-exchange scheme around the corner. To many drug users, these schemes have facilitated the elimination o f one extra problem from their stressful lifestyle: the search for clean equipment w i th which to inject. Most spend their time on a spiralling treadmill o f getting the money together for their habit, scurrying round in pursuit o f the drugs themselves, and finally consuming the chosen substances. Obtaining clean injecting equipment is often given a low priori ty in many drug users' day. Without pre-empting my own
argument, suffice it to say that the question o f availability o f sterile needles and syringes is a key issue in determining the proclivity towards the sharing o f injecting equipment, and is one that needs to be closely considered in l ight o f the desirable aim o f risk reduction.
