Rhodes Tim, Davis Mark, Judd Ali
Centre for Research on Drugs and Health Behaviour, Department of Social Science and Medicine, Imperial College London, University of London, London, UK.
Addiction. 2004 May;99(5):621-33. doi: 10.1111/j.1360-0443.2004.00692.x.
Recognizing the dearth of qualitative research on hepatitis C virus (HCV) infection associated with injecting drug use in the UK, this paper summarizes qualitative insights from a study exploring the social relations of HCV risk management among drug injectors in London.
Adopting an inductive approach to data collection and analysis, 59 depth tape-recorded qualitative interviews were undertaken in 2001 with drug injectors recruited via drug user networks.
While access to injecting equipment was reportedly good, needle and syringe sharing continued in exceptional circumstances and in the context of 'trust relationships'. Analyses of drug injectors' accounts of variations of 'I never share' showed that this construction denoted less a descriptor of actual risk behaviour than presentation of perceived risk status. Paraphernalia sharing, including spoons and filters, was common. There was much confusion and uncertainty concerning HCV knowledge, including its medical and transmission risks. Injectors were aware of the provisionality and partiality of their HCV knowledge. Confusion also surrounded the meaning of HCV antibody test results, with some feeling that their positive diagnosis had been 'trivialized' by their experiences of HCV testing. Injectors tended to make sense of HCV risk in relation to HIV. With most viewing HCV prevalence as high and HCV transmission as an inevitable consequence of injecting, HCV risk was perceived as ubiquitous and unavoidable.
There is an urgent need to renew UK policies of harm reduction in order to support perceptions that HCV is avoidable and preventable.
鉴于认识到英国针对与注射吸毒相关的丙型肝炎病毒（HCV）感染的定性研究匮乏，本文总结了一项探索伦敦吸毒者中HCV风险管理社会关系的研究中的定性见解。
采用归纳法进行数据收集和分析，2001年对通过吸毒者网络招募的吸毒者进行了59次深度录音定性访谈。
虽然据报道获取注射设备的情况良好，但在特殊情况下以及在“信任关系”背景下，针头和注射器的共用仍在继续。对吸毒者关于“我从不共用”说法变化的分析表明，这种表述与其说是对实际风险行为的描述，不如说是对感知风险状况的呈现。包括勺子和过滤器在内的用具共用很常见。关于HCV知识，包括其医学和传播风险，存在很多困惑和不确定性。注射者意识到他们的HCV知识具有临时性和片面性。关于HCV抗体检测结果的含义也存在困惑，一些人觉得他们的阳性诊断因HCV检测经历而被“轻视”。注射者倾向于根据HIV来理解HCV风险。大多数人认为HCV患病率很高，且HCV传播是注射的必然结果，因此HCV风险被视为普遍存在且不可避免。
迫切需要更新英国的减少伤害政策，以支持HCV是可避免和可预防的观念。
