Do actions speak louder than words? Perceived peer influences on needle sharing and cleaning in a sample of injection drug users

Past research (Dielman, Butchart, Shope, & Miller, 1990; Kandel, 1980) has found peer influence, perceived peer norms and perceived peer behavior as t he strongest predictors of drug use in adolescent and young adult populatio ns. The purpose of this study was to investigate whether verbal persuasion (peer norms) and/or observation of peer behavior (modeling) were significan tly associated with the injection practices of unclean needle sharing and n eedle cleaning of 642 high risk for HN infection active injection drug user s in Baltimore, Maryland, in 1991 and 1992. Using regression analyses to ex amine interview reports of infection practices, it was determined that: sub jects who reported observing more peer protective HIV-related behavior were also more likely to report lower frequencies of HN risk behavior (unclean needle sharing) and increased frequencies of HIV protective behavior (alway s cleaning needles). Reports of verbalizations of peer norms about reducing risk were not associated with decreased HN risk behavior. Reports of "enco uragement by peers to engage in cleaning needles" was paradoxically related to increased risk of sharing unclean needles. in conclusion, peer behavior rather than verbal persuasion appears to influence injection practices.