@article{cf4526d82fea4428bfe645a93583888a,
title = "Syringe-mediated drug sharing among injecting drug users: Patterns, social context and implications for transmission of blood-borne pathogens",
abstract = "Drug injectors are at risk for infection with human immunodeficiency virus (HIV) and other blood-borne pathogens through the exchange of (infected) blood resulting from unhygienic injecting practices. Research attention and public discussion have focused primarily on the sharing of syringes and needles. While the focus on syringe sharing has sparked important interventions (bleach distribution, syringe exchange) it may have obscured the social relationship in which injecting equipment is used. Drug sharing plays a crucial role in the social organization of the drug using subculture. In this paper, various drug sharing practices and other distinguishable aspects of the injecting process - collectively termed Syringe-Mediated Drug Sharing (SMDS) - are described. All of these behaviors may put injecting drug users (IDUs) at risk for infection. The purpose of this paper is to stimulate scientific inquiry into SMDS behaviors and the social contexts which shape them. Descriptions are based primarily on field studies in Rotterdam and New York City. Recommendations for safer injecting training and education are proposed, as are directions for future research.",
keywords = "Blood-borne pathogens, Drug sharing, Epidemiology, Ethnography, HIV risk factors, Injecting drug use, Social factors",
author = "Grund, {Jean Paul C.} and Friedman, {Samuel R.} and Stern, {L. Synn} and Benny Jose and Alan Neaigus and Richard Curtis and {Des Jarlais}, {Don C.}",
note = "Funding Information: Acknowledgements--The Dutch research was supported by the Nederlandse Organisatie voor Wetenschappelijk Onder-zoek (Netherlands Organization for Scientific Research), Medical Sciences Area, Social Psychiatry Working Group (grant no. 900-556-039). The American research was supported by the National Institute on Drug Abuse grant D. A.06723. Opinions expressed in the paper do not necessarily reflect policy of the supporting organizations.This paper is dedicated to the memory of Nico Adriaans, who has been instrumental in the field research upon which the first publications about syringe-mediated drug sharing were based. We thank the drug users who participated in the studies this paper is based on 1{"}or their cooperation. We also thank Andrea Efthimiou of the European Interest Group of Drug Users, Chris Jones of the New South Wales Users & AIDS Association, Dave Burrows of the International Drug Users Network, Peter Blanken of the Addiction Research Institute in Rotterdam, Martin Donoghoe of the Centre for Research on Drugs and Health Behavior in London, and Maarten van Doorninck of the Project AIDS and Drug Use, Netherlands Institute Alcohol and Drugs. They all provided important comments and suggestions for this paper. Finally we thank the anonymous reviewers for their evaluation. Funding Information: JEAN-PAUL C. GRUND, t SAMUEL R. FRIEDMAN,-' L. SYNN STERN, 3 BENNY JOSE,-' ALAN NEAIGUS\] RICHARD CURTIS 2 and DON C. DES JARLAIS 4 LThe Lindesmith Center, 888 Seventh Avenue, New York, NY 10106 and Department of Sociology, University of Connecticut, 344 Mansfield Road, U-68, Storrs, Connecticut, CT 06268, U.S.A., -'National Development and Research Institutes Inc., New York, N.Y., U.S.A., 3Eastern Connecticut Health Outreach Project, Windham Regional Community Council, Willimantic, Conn., U.S.A. and 4Beth Israel Medical Center, New York, N.Y., U.S.A.",
year = "1996",
month = mar,
doi = "10.1016/0277-9536(95)00193-X",
language = "English (US)",
volume = "42",
pages = "691--703",
journal = "Social Science and Medicine",
issn = "0277-9536",
publisher = "Elsevier Ltd",
number = "5",
}