A qualitative exploration of travel-related risk behaviours of injection drug users from two Slovene regions

Harm Reduction Journal

Danica P Rotar²  Igor Švab²  Tatja Kostnapfel¹ 

[1] Public Health Institute of Ljubljana, Slovenia;University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Ljubljana, Slovenia

关键词: semi-structured interview;    qualitative study;    injection drug users;    travel-related risk behaviours;   

Others  :  810181
DOI  :  10.1186/1477-7517-8-8

 received in 2010-09-21, accepted in 2011-04-17,  发布年份 2011

【 摘 要 】

This qualitative study of travel-related risk behaviours of Slovene injection drug users was based on interviews with individuals enrolled in drug addiction treatment programmes run by three regional centres for prevention and treatment of drug addiction. The primary objective of the study was to analyse behaviour patterns and practices of injection drug users during travel.

Methods

Travel-related problems of Slovene injection drug users were identified on the basis of data obtained by 25 in-depth interviews. A semi-structured questionnaire with 13 open-ended questions was developed after a preliminary study and review of the literature, and on the basis of experience with the treatment of drug addiction in Slovenia.

Results

The sample comprised 25 individuals, 18 men and seven women, aged 25 to 53 years. The interviews were 10 to 30 minutes long. The results obtained were presented as identified risk behaviours. Five categories were generated, providing information on the following topics: procurement of illicit drugs, criminal acts/environment, HIV and hepatitis B and C infections, storage and transport of substitution medication and pre-travel health protection. The first three categories comprise the injection drug users' risk behaviours that are most frequently explored in the literature. The other two categories - storage and transport of medication across the border and pre-travel health protection - reflect national specificities and the effectiveness of substitution treatment programmes. The majority of participants denied having shared needles and other injecting equipment when travelling. Participants who had no doctor's certificate had recourse to various forms of risk behaviour, finding a number of ways to hide the medication at the border.

Conclusion

This qualitative study provides insight into potential travel-related risk behaviour of injection drug users from two Slovene regions - central and coastal. The potential value of this qualitative study is primarily in the identification of potential risk behaviour of Slovene injection drug users travelling abroad. The study shows that injection drug users' experiences can contribute to better and more efficient treatment of drug addiction in Slovenia.

【 授权许可】

   
2011 Kostnapfel et al; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Dekleva B, Nolimal D: Paradigma zmanjševanja škode kot politika droge (In English: The paradigm of harm reduction in Slovenia). In Revija Mreža drog Edited by Dekleva B, Grund JP, Nolimal D. 1997, 2-4(5):5-7.
• [2]Krek M (Ed): Nacionalno poročilo 2009 o stanju na področju prepovedanih drog v Republiki Sloveniji. (In English: Report of the drug situation 2009 of the Republic of Slovenia) Public Health Institute of the Republic of Slovenia. Ljubljana; 2010.
• [3]Trautmann F, Rode N, Gageldonk VA, Gouve VD, Croes E, Zidar R, et al.: Evaluation of substitution maintenance treatment in Slovenia - assessing its quality and efficiency. Utrecht-Ljubljana: Trimbos Institute - Netherlands Institute of Mental Health and Addiction, Faculty of Social Work and University of Ljubljana; 2007.
• [4]Nolimal D, Kocmur D: Etnografija, obredi v zvezi z vbrizgavanjem drog in tveganje za okužbo z virusom HIV med uživalci drog v Sloveniji: ali vemo dovolj? (In English: Ethnography, rituals connected with drug injection and the risk of HIV infection among drug users in Slovenia: do we know enough?). Zdrav var 1997, 36:465-8.
• [5]Kastelic A, Kostnapfel T: Substitucijski programi zdravljenja odvisnosti od opiodov v Sloveniji. (In English: Opioid substitution treatment programs in Slovenia). Zdrav vest 2010, 79:575-81.
• [6]Kastelic A: Priporočila zdravnikom za zdravljenje odvisnosti od prepovedanih drog. (In English: Recommendations for doctors on treatment of drug addiction). In Posvetovanje o problematiki metadona: zbornik izbranih predavanj. Edited by Kostnapfel Rihtar T. Ministrstvo za zdravstvo, Ljubljana; 1995.
• [7]Krek M, Mišigoj Krek J: Občina Piran in droge. (In English: Municipality of Piran and drugs). Mreža drog 1996, 4(1):20-36.
• [8]Občasnik ZZZS Akti&Navodila. (In English: Health Insurance Institute Periodical: Documents & Guidelines) Ljubljana; 2010. no. 2/1
• [9]Bell J, Dru A, Fischer B, Levit S, Sarfraz A: Substitution therapy for heroin addiction. Subst Use Misuse 2002, 37(8-10):1149-78.
• [10]Treloar C, et al.: Valuing methadone takeaway doses: The contribution of service-user perspectives to policy and practice. Drugs: education, prevention, policy 2007, 14(1):61-74.
• [11]Goldberg DJ, Frischer M, Taylor A, Green ST, McKeganey N, Bloor M, Reid D, Cossar J: Mobility of Scottish Injecting Drug Users and Risk of HIV Infection. Eur J Epidemiol 1994, 10(4):378-92.
• [12]Lee D, Bell DC, Hinojosa M: Drug use, travel and HIV risk. AIDS care 2002, 14(4):443-53.
• [13]Elliott R, Csete J, Wood E, Kerr T: Harm Reduction, HIV/AIDS, and the Human Rights Challenge to Global Drug Control Policy. Health Hum Rights 2005, 8(2):104-138.
• [14]Wilson ME, von Reyn FC, Fineberg HV: Infections in HIV - infected Travelers: Risks and Prevention. Ann Int Med 1991, 114:582-92.
• [15]Faupel CE, Klockars CB, Drugs-Crime Connections: Elaborations from the Life Histories of Hard-Core Heroin Addicts. Soc Probl 1987, 34(1):54-68.
• [16]Hunt DE: Drugs and Consensual Crimes: Drug Dealing and Prostitution. Crime Justice 1990, 13:159-202.
• [17]Firestone M, Fischer B: A qualitative exploration of prescription opioid injection among street-based drug users in Toronto: behaviours, preferences and drug availability. Harm Reduction Journal 2008, 5:30. BioMed Central Full Text
• [18]Rhodes T, Robert L, Cesáreo F, Enzo G, Uwe EK, Hans CO, Nacer L, Imar F, Ellen Spannow K: Risk Factors Associated With Drug Use: the importance of 'risk environment'. Drugs Educ Prev Policy 2003, 10(4):303-29.
• [19]Grund JP, et al.: Syringe-mediated drug sharing among injecting drug users: patterns, social context and implications for transmission of blood-borne pathogens. Volume 2-4. Edited by Dekleva B, Grund JP, Nolimal D. Revija Mreža drog; 1997::117-134.
• [20]Rhodes T: Individual and community action in HIV prevention: an introduction. In AIDS, Drugs and prevention: perspectives on individual and community action. Volume 1. Edited by Rhodes T, Hartnoll R. London and New York: Routledge; 1996::1-9.
• [21]Fairbairn N, Small W, Van Borek N, Wood E, Kerr T, et al.: Social structural factors that shape assisted injecting practices among injection drug users in Vancouver, Canada: a qualitative study. Harm Red J 2010, 7:20. BioMed Central Full Text
• [22]Latkin CA, Mandell W, Vlahov D, Oziemkowska M, Celentano DD: The Long-Term Outcome of a Personal Network-Oriented HIV Prevention Intervention for Injection Drug Users: The SAFE Study. Am J Community Psychol 1996, 24(3):341-364.
• [23]Koester S: The Process of drug injection: applying ethnography of the study of HIV risk among IDUs. In AIDS, Drugs and prevention: perspectives on individual and community action. Volume 9. Edited by Rhodes T, Hartnoll R. London and New York: Routledge; 1996::133-148.
• [24]Rhodes T: The multiple roles of qualitative research in understanding and responding to illicit drug use. In Understanding and responding to drug use: the role of qualitative research. Volume 4. EMCDDA Scientific Monographs Series; 2000::21-36.
• [25]Rhodes T, Watts L, Davies S, Martin A, Smith J, Clark D, Craine N, Lyons M: Risk, shame and the public injector: A qualitative study of drug injecting in South Wales. Social Science & Medication 2007, 65:572-85.
• [26]Nolimal D, Weber I: General terms in ethnographic research. Med Razgi 1996, 35(5):169-79.
• [27]Matteelli A, Carosi G: Sexually Transmitted Diseases in Travelers. Clin Infect Dis 2001, 32(7):1063-7.
• [28]Salit IE, Sano M, Boggild AK, Kain KC: Travel patterns and risk behaviour of HIV-positive people travelling internationally. CMAJ 2005, 172(7):884-8.
• [29]Klavs I, Kustec T, Bergant N, Kastelic Z: Okužba s HIV v Sloveniji: letno poročilo 2009 (In English: HIV infections in Slovenia - Report for year 2009). Public Health Institute of the Republic of Slovenija, Ljubljana; 2009.
• [30]Statistics and country data. Country overview: Slovenia [http://www.emcdda.europa.eu/publications/country-overviews/si] webciteEuropean Monitoring Centre for Drugs and Drug Addiction, EMCDDA; 2010. (Accessed: December 5, 2010)
• [31]Meyer J: Qualitative research in health care: Using qualitative methods in health related action research. BMJ 2000, 320(7228):178-81.
• [32]Golafshani N: Understanding Reliability and Validity in Qualitative Research. The qualitative Report 2003, 8-4:597-607.
• [33]Saldana J: The coding manual for qualitative researchers. Los Angeles [etc.]: Sage; 2009.
• [34]Neale J, Sheard L, Tompkins CNE: Factors that help injecting drug users to access and benefit from services: A qualitative study. Substance Abuse Treatment, Prevention, and Policy 2007, 2:31. BioMed Central Full Text
• [35]Pisec A: 1995-2001 programme evaluation of the A-center fot treatment of addicts consuming prohibited drugs at Maribor, Slovenia. Heroin add & Rel Clin Probl 2002, 4(1):25-28.
• [36]Čuk Rupnik J: Treatment of Heroin Addiction with Methadone in the Centre for Prevention and Treatment of Addiction of Illicit Drugs Logatec. Zdrav Vestn 2008, 77:377-82.