Venous access and care: harnessing pragmatics in harm reduction for people who inject drugs
Version of Record online: 13 FEB 2012
© 2011 The Authors, Addiction © 2011 Society for the Study of Addiction
Volume 107, Issue 6, pages 1090–1096, June 2012
How to Cite
Harris, M. and Rhodes, T. (2012), Venous access and care: harnessing pragmatics in harm reduction for people who inject drugs. Addiction, 107: 1090–1096. doi: 10.1111/j.1360-0443.2011.03749.x
- Issue online: 4 MAY 2012
- Version of Record online: 13 FEB 2012
- Accepted manuscript online: 7 DEC 2011 08:54AM EST
- Submitted 18 July 2011; initial review completed 31 August 2011; final version accepted 1 December 2011
- Harm reduction;
- hepatitis C;
- injecting drug use;
- vein care
Aim To explore the facilitators of long-term hepatitis C avoidance among people who inject drugs.
Design We employed a qualitative life history design.
Setting Recruitment took place through low-threshold drug services and drug user networks in South East and North London. Participants were interviewed at the recruitment services or in their homes.
Participants The sample comprised 35 people who inject drugs, 20 of whom were hepatitis C antibody-negative. Participants' average injecting trajectory was 19 years (6–33), with 66% primarily injecting heroin, and 34% a crack and heroin mix. Nine (26%) of the sample were female and the average age was 39 years (23–53).
Measurements Two interviews were conducted with each participant, with the second interview incorporating reference to a computer-constructed life history time-line. Interview accounts were audiorecorded, transcribed verbatim and analysed thematically.
Findings Hepatitis C risk awareness was recent and deprioritized by the majority of participants. The facilitation of venous access and care was an initial and enduring rationale for safe injecting practices. Difficult venous access resulted in increased contamination of injecting environments and transitions to femoral injecting. Participants expressed an unmet desire for non-judgemental venous access information and advice.
Conclusions Harm reduction interventions which attend to the immediate priorities of people who inject drugs, such as venous access and care, have the potential to re-engage individuals who are jaded or confused by hepatitis C prevention messages.