Using the health belief model to predict injecting drug users' intentions to employ harm reduction strategies.

We examined whether perceived susceptibility to and severity of two injection-related health conditions (i.e., non-fatal overdose and bacterial infections), and perceived benefits of, barriers to, self-efficacy to, social acceptance of, and recent use of two harm-reduction behaviors (i.e., injecting test shots and pre-injection skin cleaning), predicted injecting drug users' near-term intentions to engage in these two strategies. Recent past use of these two behaviors consistently and positively predicted near-term intentions in each of four drug-use situations (i.e., in withdrawal, not in withdrawal, alone, and with others). Perceived susceptibility to non-fatal overdose predicted intentions to do test shots, but only when participants imagined not being in withdrawal or injecting when alone. Perceived self-efficacy to clean one's skin predicted intentions to engage in this behavior, but only when participants imagined injecting while not in withdrawal. Participants' ratings of how often other injectors in their social network engage in pre-injection skin cleaning was also a significant positive predictor of intentions to clean one's skin, but only when they imagined being in withdrawal. Finally, length of time attending the needle exchange program was negatively associated with intention to engage in skin cleaning when not in withdrawal.