How rational is needle sharing to young injecting drug users?

Rational Decision-Making (RDM) models, which focus on individuals' cognitio ns and attitudes, have been applied to the explanation of HIV/AIDS risk beh aviour. The concept of rational choice which underpins RDM models has, howe ver, been found to be inadequate to explain young people's sexual risk-taki ng behaviour. The current paper uses primarily qualitative data from a stud y of HIV/AIDS risk behaviour among young drug injectors to explore whether or not needle sharing behaviour could be explained by RDM models. In genera l, we found it could not: some young injectors, despite knowing that HIV ca n be transmitted through needle sharing and that AIDS is fatal, continued t o share needles. It was clear, however, that behaviour that appeared irrati onal from the perspective of RDM models, was not irrational from the perspe ctive of the actors. The paper concludes with a plea for health promotion a nd education to be based on understandings of injecting risk behaviour whic h address all the individual, cultural and societal constraints that operat e to prevent young injectors from acting safely.