injecting drug use, the HIV risks associated

One of the difficulties lies in the fact that in the context of everyday injecting drug use, the
HIV risks associated with injection may seem less immediate or important than other risks, such
as overdose, vein damage or addiction.
“You don’t care when you need a dose. The fear of remaining sober and in pain overwhelms
any fear of sickness.” Andrei, Siberia [16].
Heroin Injecting in India: direct and indirect sharing
Transitions from chasing heroin to injecting have occurred among young persons rapidly in
Chennai, India. Typically, one young injector takes responsibility for preparing and dividing the
drug, usually heroin.
The individual responsible for the preparation places it in the cooker (usually a spoon or an
alcohol bottle cap), and then, using their syringe (the donor syringe) draws up water and
discharges it into the cooker. The drug is then stirred with the syringe plunger until it dissolves.
The entire solution is then drawn through a cotton filter and into the donor syringe. The same
injector measures the total amount of the drug to determine each injector’s share. Once portions
are calculated, the IDU preparing the drug distributes it by skirting all but their share of the
solution back into the cooker or directly in to the other injectors’ syringes.
Rapid Assessment Report, Chennai, India, 2001 Sexual risk behaviour
Sexual risk behaviour is common and difficult to change in IDUs. They often do not recognize
the importance of safe sexual practices and can become links who transmit the HIV virus to
non-injecting populations.
“Most people I know say ‘Oh, my boyfriend or girlfriend doesn’t have AIDS, because look
at her, she’s healthy and wouldn’t do stuff like that’. But people don’t realize that if you
have a relationship with someone, you’re sleeping with all the people they slept with. If
you don’t use a condom, you might get what all those other people had.” Joretta, 15 [17].
Risky sexual behaviour includes:
Vaginal and anal intercourse and oral sex without the use of a condom.
Having multiple partners.
Lack of treatment for other STIs which can increase the change of HIV transmission.
High-risk injection and sexual behaviour often go hand in hand. IDUs also often use other
drugs such as alcohol, which have been related to high-risk sexual behaviour due to their
disinhibiting effect.