SYRINGE-MEDIATED DRUG SHARING AMONG INJECTING DRUG-USERS - PATTERNS, SOCIAL-CONTEXT AND IMPLICATIONS FOR TRANSMISSION OF BLOOD-BORNE PATHOGENS

Drug injectors are at risk for infection with human immunodeficiency v irus (HIV) and other blood-borne pathogens through the exchange of (in fected) blood resulting from unhygienic injecting practices. Research attention and public discussion have focused primarily on the sharing of syringes and needles. While the focus on syringe sharing has sparke d important interventions (bleach distribution, syringe exchange) it m ay have obscured the social relationship in which injecting equipment is used. Drug sharing plays a crucial role in the social organization of the drug using subculture. In this paper, various drug sharing prac tices and other distinguishable aspects of the injecting process-colle ctively termed Syringe-Mediated Drug Sharing (SMDS)-are described. All of these behaviors may put injecting drug users (IDUs) at risk for in fection. The purpose of this paper is to stimulate scientific inquiry into SMDS behaviors and the social contexts which shape them. Descript ions are based primarily on field studies id Rotterdam and New York Ci ty. Recommendations for safer injecting training and education are pro posed. as are directions for future research.