Drug injecting and HIV risk among injecting drug users in Hai Phong, Vietnam: a qualitative analysis

BMC Public Health

Donald Edwin Stewart¹  Phan Thi Huong²  Thanh Nguyen Long²  Tanvir Ahmed¹ 

[1] School of Medicine, Griffith University, Griffith Graduate Centre, South Bank Campus, 226 Grey Street, South Brisbane QLD 4101, Australia;Vietnam Authority of HIV/AIDS Control, Lane 135/3 Nui Truc Street, Ba Đinh District, Hanoi, Vietnam

关键词: Prevention;    Harm reduction;    Qualitative;    Sharing;    Vietnam;    Injecting drug user;    HIV;   

Others  :  1122836
DOI  :  10.1186/s12889-015-1404-3

 received in 2014-08-14, accepted in 2015-01-12,  发布年份 2015

【 摘 要 】

Background

Hai Phong, located in northern Vietnam, has become a high HIV prevalence province among Injecting Drug Users (IDUs) since the infection shifted from the southern to the northern region of the country. Previous research indicates high levels of drug and sex related risk behaviour especially among younger IDUs. Our recent qualitative research provides a deeper understanding of HIV risk behaviour and highlights views and experiences of IDUs relating to drug injecting and sharing practices.

Methods

Fifteen IDUs participated in semi-structured interviews conducted in September-October, 2012. Eligible participants were selected from those recruited in a larger scale behavioural research project and identified through screening questions. Interviews were conducted by two local interviewers in Vietnamese and were audiotaped. Ethical procedures, including informed consent and participants’ understanding of their right to skip and withdraw, were applied. Transcripts were translated and double checked. The data were categorised and coded according to themes. Thematic analysis was conducted and a qualitative data analysis thematic framework was used.

Results

Qualitative analysis highlighted situational circumstances associated with HIV risks among IDUs in Hai Phong and revealed three primary themes: (i) places for injecting, (ii) injecting drugs in small groups, and (iii) sharing practices. Our results showed that shared use of jointly purchased drugs and group injecting were widespread among IDUs without adequate recognition of these as HIV risk behaviours. Frequent police raids generated a constant fear of arrest. As a consequence, the majority preferred either rail lines or isolated public places for injection, while some injected in their own or a friend’s home. Price, a heroin crisis, and strong group norms encouraged collective preparation and group injecting. Risk practices were enhanced by a number of factors: the difficulty in getting new syringes, quick withdrawal management, punitive attitudes, fear of arrest/imprisonment, lack of resources, incorrect self-assessment, and risk denial. Some of the IDU participants emphasised self-care attitudes which should be encouraged to minimise HIV transmission risk.

Conclusion

The IDUs’ experiences in Hai Phong identified through our data broaden our qualitative understanding about the HIV transmission risk among IDUs and emphasize the need to strengthen harm reduction services in Vietnam.

【 授权许可】

   
2015 Ahmed et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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