Social structural factors that shape assisted injecting practices among injection drug users in Vancouver, Canada a qualitative study 英文参考文献.docVIP

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Social structural factors that shape assisted injecting practices among injection drug users in Vancouver, Canada a qualitative study 英文参考文献.doc

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Social structural factors that shape assisted injecting practices among injection drug users in Vancouver, Canada a qualitative study 英文参考文献

Fairbairnetal.HarmReductionJournal2010,7:20 /content/7/1/20 RESEARCH OpenAccess Socialstructuralfactorsthatshapeassisted injectingpracticesamonginjectiondrugusers inVancouver,Canada:aqualitativestudy NadiaFairbairn1,WillSmall1,NatashaVanBorek1,EvanWood1,2,ThomasKerr1,2* Abstract Background:Injectiondrugusers(IDU)commonlyseekmanualassistancewithillicitdruginjections,apractice knowntobeassociatedwithvarioushealth-relatedharms.Weinvestigatedthesocialstructuralfactorsthatshape risksrelatedtoassistedinjectionandtheharmsthatmayresult. Methods:Twentysemi-structuredqualitativeinterviewswereconductedwithIDUenrolledintheACCESSor VancouverInjectionDrugUsersStudy(VIDUS)whoreportedrequiringassistanceinjectinginthepastsixmonths. Audio-recordedinterviewsweretranscribedverbatimandathematicanalysiswasconducted. Results:Barrierstoself-injectingincludedalackofknowledgeofproperinjectingtechnique,alossofaccessible veins,anddrugwithdrawal.Theexchangeofmoneyordrugsforassistancewithinjectingwascommon.Harms experiencedbyIDUrequiringassistanceinjectingincludedtheftofthedrug,missedinjections,overdose,andrisk ofblood-bornediseasetransmission.IncreasedvulnerabilitytoHIV/HCVinfectionwithinthecontextofintimate relationshipswasrepresentedinparticipantnarratives.IDUidentifiedalackofservicesavailableforthosewho requireassistanceinjecting,withnotablementionofrestricteduseofVancouver’ssupervisedinjectionfacility. Conclusions:Thisstudydocumentsnumeroussevereharmsthatarisefromassistedinjecting.Socialstructural factorsthatshapetherisksrelatedtoassistedinjectionintheVancouvercontextincludedintimatepartner relationsandsocialconventionsrequiringanexchangeofgoodsforprovisionofinjectingassistance.Health servicesforIDUwhoneedhelpinjectingshouldincludetargetedinterventions,andsupervisedinjectionfacilities shouldattempttoaccommodateindividualswhorequireassistancewithinjecting. Introduction Recentstudieshavedemonstratedthat,evenwhenster- The injection ofillicit drugs is agrowing public health ileneedlesareacces