title: A qualitative investigation into an HIV outbreak among injection drug users in Vancouver, British Columbia.
abstract: The proportion of injection drug users (IDUs) testing positive for Human Immunodeficiency Virus (HIV) in British Columbia has increased from 3 to 7% since January 1993 (Patrick et al., 1997). We conducted a qualitative study as a first step in a case control investigation aimed at identifying risk factors associated with HIV seroconversion. Sixteen subjects participated in in-depth interviews which were transcribed and analysed using grounded theory methods. Three dominant themes emerged: Addiction, Prevention, and Social Determinants. The results suggest that prevention efforts such as the availability of clean needles and condoms are not adequate to combat the complex social determinants of addiction--be they causal or consequential--which in turn contribute to unsafe injection practices.
authors.affiliation: St. Paul's Hospital, Vancouver, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Harvey
authors.forename: S A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: D M
authors.initials: DM
authors.lastname: Patrick
authors.forename: M
authors.initials: M
authors.lastname: Ofner
authors.forename: C P
authors.initials: CP
authors.lastname: Archibald
authors.forename: G
authors.initials: G
authors.lastname: Eades
authors.forename: M V
authors.initials: MV
authors.lastname: O'Shaughnessy
mesh_terms: D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D016022:Case-Control Studies; D004196:Disease Outbreaks; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D016485:Needle Sharing; D011287:Prejudice; D012307:Risk Factors; D012924:Social Conditions; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*