The Context of HIV Risk Among Drug Users and Their Sexual Partners

By the 100th interview, the screening question was revised to open up the
answers. The revised questions were: “Tell me about the first time you
ever injected any illicit drugs. How did you get the needle or syringe to
inject the drug?” “For how long did you ever use other people’s syringes
or works?” “How many people did you share a syringe with?” “Did you
ever share needles with anyone else after the first time?” At the
conclusion of the remaining 260 interviews, the same kinds of disparities
were found as in the first 100: roughly 30 percent who reported injection
stated that they had never shared. In other words, the revised wording
did not elicit any better responses than the simple screening question had.
The investigator decided to simply take people at their word and used two
codes for the question: shared or did not share. However, the investigator
was suspicious of these reports and believes that a sizeable number of the
respondents underreported sharing.
Despite these problems, the study found that there was considerable
sharing and a good deal of it took place in communal settings such as
shooting galleries, sex clubs, and bath houses. More than 7 out of
10 (79.4 percent) of 192 injectors from the first sample reported sharing
syringes. Syringe sharing occurred among a variety of relationships and
social situations: with friends, roommates, and intimates and in
communal settings such as shooting galleries, sex clubs, and bath houses.
More than 3 out of 10 (30.2 percent) of those who had shared syringes
reported sharing in shooting galleries, and a sixth (15.1 percent) reported
sharing in bath houses and sex clubs. (Refer to Waldorf et al. 1990 and
Waldorf and Murphy 1990 for more detailed findings.)
For the second survey, which focused primarily on condom use but also
asked about drug injection, the syringe-sharing questions were redesigned
and consolidated into two questions. Here is how the questions were
worded: “Tell me about the first time you ever injected any drug. Did
you have your own syringe, or did you use someone else’s?” “Have you
ever been forced by circumstances to use a needle that someone else had
used previously without cleaning it with bleach?”
This revision produced the following results for the second survey:
nearly two-thirds of the sample reported injecting drugs (63.8 percent),
and only 56.3 percent of injectors reported that they shared syringes the
first time they injected. Roughly half (54.8 percent) reported that they
had used another person’s syringe without cleaning it with bleach.
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