“…I can use any syringe I find”: contextual determinants of HIV risk in public injecting settings in Nigeria
ISSN: 1745-9265
Article publication date: 11 December 2020
Issue publication date: 11 December 2020
Abstract
Purpose
The purpose of this study is to explore the contextual determinants of HIV risk among people who inject drugs (PWID) in public settings in Nigeria.
Design/methodology/approach
In-depth, individual interviews were conducted with 29 street-based PWID recruited through snowball sampling in Uyo, Nigeria. Interviews were tape-recorded, transcribed, coded and analysed hematically.
Findings
Homelessness and withdrawal pains encouraged consumption of drugs in public spaces (e.g. bunks, public parks). Conversely, the benefits of participation in street drug-use scenes, including reciprocity norms that guarantee free drugs during withdrawal and protection during overdose, fostered a preference for public injecting. Although participants recognized the need to inject with sterile syringes, scarcity of syringes compelled them to improvise with old syringes or share syringes, increasing risk for HIV transmission. HIV risk was exacerbated by unlawful and discriminatory policing practices, which deterred possession of syringes and encouraged risky behaviours such as rushing injection and sharing of equipment.
Practical implications
Contextual factors are key determinants of HIV risk for street-based PWID. Implementation of needle and syringe programmes as well as reforming legal frameworks and policing practices to support harm reduction are needed responses.
Originality/value
This is one of very few qualitative studies that explore risk factors for HIV transmission among PWID in West Africa. The focus on scarcity of sterile syringes and HIV risk is unique and has important policy implications.
Keywords
Acknowledgements
The authors are grateful to the participants for sharing their views, and to the anonymous reviewers for Drug and Alcohol Today, for their critical comments that greatly enriched the work.
Citation
Nelson, E.-U.E. and Nnam, M.U. (2020), "“…I can use any syringe I find”: contextual determinants of HIV risk in public injecting settings in Nigeria", Drugs and Alcohol Today, Vol. 20 No. 4, pp. 371-381. https://doi.org/10.1108/DAT-05-2020-0031
Publisher
:Emerald Publishing Limited
Copyright © 2020, Emerald Publishing Limited