title: Situational factors influencing drug injecting, risk reduction and syringe exchange in Togliatti City, Russian Federation: a qualitative study of micro risk environment.
abstract: We undertook a qualitative study to explore the micro-environment of drug injecting, risk reduction and syringe exchange practices among injecting drug users (IDUs) in Togliatti City, Russia. Semi-structured qualitative interviews (n=57) were undertaken with current IDUs in May 2001. Findings highlight a recent transition away from hanka (a home-produced liquid opiate derived from opium poppy) towards the injection of heroin powder, and a drug use culture in which injecting predominates. Findings emphasise that risk reduction practices may be influenced less by availability of injecting equipment than by an interplay of situational and micro-environmental factors. Principal among these is a reported fear of police detainment or arrest among IDUs which encourages a reluctance to carry needles and syringes, and which in turn, is associated with needle and syringe sharing at the point of drug sale. We note the role of policing practices in influencing risk reduction and the potential role of policing agencies in supporting HIV prevention initiatives among IDUs.
authors.affiliation: Department of Social Science and Medicine, The Centre for Research on Drugs and Health Behaviour, University of London, Reynolds Building, St Dunstan's Road, SW6 8RP, London, UK. t.rhodes@ic.ac.uk <t.rhodes@ic.ac.uk>
authors.forename: Tim
authors.initials: T
authors.lastname: Rhodes
authors.forename: Larissa
authors.initials: L
authors.lastname: Mikhailova
authors.forename: Anya
authors.initials: A
authors.lastname: Sarang
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Lowndes
authors.forename: Andrey
authors.initials: A
authors.lastname: Rylkov
authors.forename: Mikhail
authors.initials: M
authors.lastname: Khutorskoy
authors.forename: Adrian
authors.initials: A
authors.lastname: Renton
mesh_terms: D000293:Adolescent; D000328:Adult; D017848:Blood-Borne Pathogens; D004335:Drug and Narcotic Control; D005260:Female; D015658:HIV Infections / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing / Q000009:adverse effects / Q000523:psychology*; D018671:Needle-Exchange Programs; D016495:Police; D036301:Qualitative Research; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012426:Russia; D015819:Substance Abuse, Intravenous / Q000523:psychology* / Q000821:virology; D013594:Syringes