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Injecting drug use (IDU) has traditionally been seen as a law enforcement problem and a stain on society. With the emergence of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), however, the discourse on IDU has widened to include crucial public health and human rights concerns. Economic analysis, too, has much to contribute to the policy debate. By examining the costs and benefits of drug use from the perspective of injecting drug users, economic analysis can shed light on the problem of IDU and the transmission of HIV among users. This chapter also presents new results on the economic analysis of needle exchange programmes.

The purpose of this paper is to explore how injecting opiate users on a methadone treatment programme experience stigma as drug addicts, and as service users in health care and pharmacy settings. In particular the paper explores the rationale for injecting drugs, which the paper is argued to create the conditions for experiencing shame at the micro interactional level, influenced by macro institutional factors. The paper links this issue of being an injecting drug user in treatment to question whether the definition of recovery as “drug free” in the Scottish drug policy document The Road to Recovery (2008) creates the potential for stigma of service users receiving methadone maintenance treatment.

In all, 14 participants, all of whom identified themselves as problem intravenous users of drugs, were recruited from three voluntary sector (third sector) treatment agencies in Scotland. Participants took part in semi-structured interviews; these were recorded, transcribed and qualitatively analysed thematically.

Participants describe feelings of stigma in relation to their drug taking as problem users. Their experiences as recovering opiate injectors raises further challenges in distancing themselves from stigmatised addict identities.

Reasons for injecting rather than smoking heroin were principally financially challenging a widely held belief that users inject primarily for pleasure, which is argued as increasing the potential for stigma. Shame and perceived discrimination was documented before and during drug treatment.

This paper aims to explore the cessation of injecting amongst male drug users when in prison in England and uncovers what influenced this behaviour and why.

Qualitative interviews were conducted with 30 male drug users on release from prison to explore what happened to their injecting drug use in prison. The research was conducted from a pragmatic harm reduction approach using grounded theory.

Not injecting in prison was identified as a pertinent finding and nine overarching themes accounted for this decline. The themes often overlapped with one another, highlighting how the decision not to inject when last in prison was multi‐factorial. Running throughout the themes were participants' concerns regarding the health and social risks attributed to injecting in prison, alongside an appreciation of some of the rehabilitative measures and opportunities offered to injecting drug users when in prison.

This qualitative research offers an updated perspective on illicit drug injecting in prison in England from the view of drug users since health and prison policy changes in prescribing and practice. It contributes to evidence suggesting that prisons can be used as a time of reprieve and recovery from injecting drug use.

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.

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.

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.

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.

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.

The purpose of this paper is to explore prison drug injecting prevalence, identify any changes in injecting prevalence and practice during imprisonment and explore views on prison needle exchange.

An empirical prospective cohort survey conducted between 2006 and 2008. The study involved a random sample of 267 remand and sentenced prisoners from a large male category B prison in England where no prison needle exchange operates. Questionnaires were administered with prisoners on reception and, where possible, at one, three and six months during their sentence.

In total, 64 per cent were injecting until admission into prison. The majority intended to stop injecting in prison (93 per cent), almost a quarter due to the lack of needle exchange (23 per cent). Yet when hypothetically asked if they would continue injecting in prison if needle exchange was freely available, a third of participants (33 per cent) believed that they would. Injecting cessation happened on prison entry and appeared to be maintained during the sentence.

Not providing sterile needles may increase risks associated with injecting for prisoners who continue to inject. However, providing such equipment may prolong injecting for other prisoners who currently cease injecting on account of needle exchange programmes (NEPs) not being provided in the UK prison setting.

Not providing sterile needles may increase risks associated with injecting for prisoners who continue to inject. However, providing such equipment may prolong injecting for other prisoners who currently cease injecting on account of NEPs not being provided in the UK prison setting.

This survey is the first to question specifically regarding the timing of injecting cessation amongst male prisoners and explore alongside intention to inject should needle exchange facilities be provided in prison.

In Kyrgyzstan the prevalence of injecting drug behaviour is among the highest found throughout the world. Health promotion training, improved health care and needle/syringe exchange (NSE) programmes have been shown to decrease risk behaviour among injecting drug users. In Kyrgyzstan, an intervention study with training of prison staff and prisoners was performed in one prison. Before and after the training, a random selection of the prisoners answered a questionnaire about drug use, risk behaviour and health care. The survey was carried out in both the intervention prison and in a reference prison. The number of drug users, the use of drugs and risk behaviour were improved significantly within half a year and, especially, the injection and use of drugs decreased in the intervention group. The study clearly shows that increased focus, improved healthcare and training of prisoners and staff on drug use and harm reduction can reduce both use of drugs and risk behaviour.

The purpose of this paper is to describe HIV-related risk behavior and knowledge of HIV among inmates of Kerobokan prison Bali, Indonesia.

A cross-sectional survey of inmates of using a structured questionnaire and sample framework to reflect narcotic use among inmates and the prison gender mix.

Among 230 inmates recruited to the study self-reported prevalence of injecting drug use was 7.4 percent (95 percent CI 4.0-10.8percent). Respondents who participated in a prison based methadone treatment program were all still injecting drugs, these made up 13/17 of the IDU. In total, 47 percent (95 percent CIs 45-55 percent) of respondents who reported injecting also reported sharing needles within the last week. Sexual intercourse while in prison was reported by 3.0 percent (95 percent CI 0.82-5.26 percent) of study respondents. One-third of non-injectors were unaware of the preventative role of condom use. This study suggests that despite harm reduction initiatives within Kerobokan prison HIV risk behavior continues and there is a considerable lack of awareness of the importance of condom use in preventing HIV.

The authors relied on self-reported risk behavior that may be subject to reporting bias. The sampling strategy may not reflect the true ratio inmates using or not using narcotics.

The current harm reduction approach, including methadone substitution treatment should be optimized within the Indonesian prison setting.

This is the first study reporting HIV-related risk behavior from an Indonesian prison with an established methadone substitution program.

The United States of America is in the midst of an opioid crisis. However, little has been written within the domain of LIS (Library and Information Science) about the health information needs and behaviors of people who inject drugs. The purpose of this project is to conduct a scoping review of the current knowledge disseminated by LIS scholars and professionals regarding what information people who inject drugs have access to, need, how they interact with information and what dissemination methods may be most beneficial.

A scoping review of the literature was conducted with the additional inclusion criteria that the information needs be expressed from the insider perspective of this population instead of from the researcher.

In searching over a dozen databases, only seven articles were found that reflected the information behaviors of people who use drugs from the perspective of themselves. Only one article was from information science, two were from health informatics and one was from health communication, a closely linked field. These findings describe the information behaviors and needs of this population and speak to the need for more comprehensive research in this area in order to create targeted health information resources for this sensitive population.

There is little research in the domain of information science that has been conducted into the health information-seeking behaviors of people who inject drugs. Most of the work in this area is from the perspective of the researcher, not the person who injects drugs. This exploration into the literature on the information behavior of people that inject drugs from the perspective of themselves is unique.

1. There is very little research that has been conducted into the health information-seeking behaviors of people who inject drugs.

2. Most of the work in this area is from the perspective of the researcher, not the person who injects drugs.

3. Only four such articles were found in the domain of LIS and seven, in total, between all academic domains.

There is very little research that has been conducted into the health information-seeking behaviors of people who inject drugs.

Most of the work in this area is from the perspective of the researcher, not the person who injects drugs.

Only four such articles were found in the domain of LIS and seven, in total, between all academic domains.

This study aims to optimize the parametric combination of injected slub yarn to achieve least abrasive damage on fabrics produced from it.

Single base injected slub yarn structural parameters, vis-à-vis slub length, slub thickness and slub frequency, were varied during preparation of yarn samples under this research work. A total of 17 yarn samples were produced according to the Box and Bhenken design of the experiment. Subsequently knitted and woven (using injected slub yarns in the weft only) fabric samples were prepared from these yarns. Yarn and fabric samples were abraded with standard instruments to see the impact of yarn structural parameters on abrasive damage of fabric in terms of fabric mass loss and appearance deterioration. From the test results, empirical models relating to slub parameters and fabric abrasion behavior were developed through a backward elimination regression approach. Subsequently, a set of optimal parametric combinations was derived with multi-objective evolutionary algorithms by using MATLAB software. This was followed by ranking all optimal solutions through technique for order preference by similarity to idle solution (TOPSIS) score analysis.

The injected slub yarn’s structural parameters have a strong influence on the abrasive damage of knitted and woven fabric. It is seen that the best suitable parametric combination of slub parameters for achieving the least abrasive damage is not the same for knitted and woven fabric.

The spinner can explore this concept to find out the best suitable parametric combination during pattern making of injected slub yarn through MATLAB solution followed by TOPSIS score analysis based on their priority of criteria level to ensure better abrasion behavior of fabric produced.

Optimization of parametric combination of injected slub yarns will help to ensure production of fabric with most resistance to abrasion for specific applications. The studies showed that the optimal solution for woven and knitted fabrics is different. The result indicates that in the case of knitted fabric, comparatively lesser slub thickness is found to be suitable for getting better fabric abrasion resistance, whereas in the case of woven fabric, comparatively higher slub thickness is found suitable for the same.

The purpose of this paper is to examine patterns of drug use among a cohort of drug treatment-seeking drug-using gay men and other men who have sex with men (MSM), and whether these activities differ between, or predict, HIV status.

Cross-sectional study was conducted in a specialist club drug clinic in London covering 407 consecutive attendees who identified as MSM. Substance use, including injecting drug use (IDU), associated sexual activity and self-reported HIV status were measured by clinical interview and National Drug Treatment Monitoring System data tool.

Over a 45-month period, 407 MSM attended the clinic. In total, 62.1 per cent were HIV positive, 48.9 per cent had injected drugs, 14.9 per cent reported needle sharing and 73.3 per cent used drugs to facilitate sex. The most commonly reported problem drugs were GHB/GBL (54.3 per cent) methamphetamine (47.7 per cent) and mephedrone (37.8 per cent). HIV status was associated with methamphetamine, mephedrone, IDU, sharing equipment, using drugs to facilitate sex, older age and older age of drug initiation, as well as Hepatitis C virology (HCV) status. Use of methamphetamine, HCV infection, older age and IDU predicted HIV positive status in a logistic regression model.

The findings describe a constellation of risk factors including high levels of IDU, sharing of equipment and high-risk sexual activity in a population with high rates of HIV positive serology. They also provide further evidence for a link between HIV infection and use of methamphetamine.

The authors suggest a need for greater awareness of HIV-related risk activities and promotion of HIV prevention strategies for MSM by both sexual health and drug treatment services.

This paper is amongst the very first studies of its nature.