De l’influence du type de substance injectée sur le comportement du partage du matériel d’injection
Among behaviors considered as public health concerns in the Quebec population, those that concern the abuse or addiction to drugs are major. Intravenous drug use is an essential part of drug use dynamics because this mode of consumption is considered to be a risk for the spread of viral infections, in particular through the sharing of injection equipment. Although this practice has declined in the last two decades in Quebec, it has not disappeared and seems to have stabilized in recent years. Since not all intravenous drug users share their injection equipment, it is important to identify the factors that contribute to the persistence of such behavior in order to develop effective measures that can stem this problem. In addition to the individual characteristics of people who inject drugs and the socioenvironmental contexts in which this consumption occurs, several actors recommend that the influence of substances consumed on injection practices be taken into account. In order to do this, we chose to examine the role and influence that the injected substance may have on the behavior of sharing injection equipment by soliciting the experience of people who inject drugs. Nine participants were selected through four community organizations in Montreal, Quebec and Gatineau to participate in a semi-directed, individual interview on specific episodes of substance use. The objective was to better understand the meaning they give to their injections experiences, with or without the sharing of equipment, as well as the types of sequences and the underlying mechanisms that are at work between the injection of a specific drug and the sharing of injection equipment. This study shows that the influence of the injected substance on injection behavior is considerable and has several aspects. Thus, the chemical composition, physical composition, economic dimensions and cultural norms associated with the various substances act in ways that are either common to all the drugs injected or specific to each of them. In the first case, the sharing of injection equipment seems to be mainly influenced by the centralization of the process of preparation of the injections and by the sharing of the substance consumed between several consumers. In the second, we observe the influence of the degree of confusion induced by the intoxication by a substance, the feeling of urgency resulting from the symptoms related to the suppression of its effects, the frequency of injection necessary to maintain them, and the process of preparation which is sometimes unique to it. Ultimately, the influence of the injected substance on the behavior of sharing injection equipment, and the resulting degree of vulnerability, seems to be due to the combination of these factors, since these factors have the potential to amplify or mitigate each other.
Drug sharing Injecting risk behavior Injection drug use Needle sharing Sharing drug paraphernalia