HIV RISK BEHAVIORS ASSOCIATED WITH THE INJECTION PROCESS - MULTIPERSON USE OF DRUG INJECTION EQUIPMENT AND PARAPHERNALIA IN INJECTION-DRUG USER NETWORKS

This study examines drug acquisition and multiperson use of parapherna lia, drugs, and needles/syringes. Ethnographers observed 54 injection episodes in which IDUs were linked by HIV risk behaviors, and develope d a typology of higher-risk, lower-risk, and nonsharing-risk networks. Multiperson use of injection paraphernalia or drug solution occurred in most injection events (94%). Serial use of syringes/needles occurre d infrequently (14%) relative to ''backloading'' (37%) and reuse of pa raphernalia (cookers 84%, cotton 77%, water 77%). Higher-risk injectio n networks were characterized by larger size and pooling of resources for drugs. Prevention messages must include avoiding reuse of injectio n paraphernalia and transfer of drug solution.