Injecting-related trust, cooperation, intimacy, and power as key factors influencing risk perception among drug injecting partnerships

• Published in: PloS one 2019-05, Vol.14 (5), p.e0217811
• Main Authors: Morris, Meghan D, Andrew, Erin, Tan, Judy Y, Maher, Lisa, Hoff, Colleen, Darbes, Lynae, Page, Kimberly
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Addictive behaviors; Adult; AIDS; Archives & records; Biology and Life Sciences; Cooperation; Couples; Disease transmission; Drug abuse; Drug use; Engineering and Technology; Epidemiology; Female; Hepacivirus - pathogenicity; Hepatitis; Hepatitis C; Hepatitis C - psychology; Hepatitis C - transmission; Hepatitis C - virology; Heroin; Heroin Dependence - psychology; Heroin Dependence - virology; HIV; HIV - pathogenicity; HIV Infections - psychology; HIV Infections - transmission; HIV Infections - virology; Human immunodeficiency virus; Humans; Injection; Interpersonal Relations; Male; Marginalized groups; Medicine and Health Sciences; Needle Sharing; Partnerships; Perception; Qualitative research; Risk Factors; Risk perception; Risk-Taking; Sexual behavior; Sexual Behavior - psychology; Sexual Partners - psychology; Social exchange theory; Social Sciences; Studies; Substance Abuse, Intravenous - psychology; Substance Abuse, Intravenous - virology; Trust - psychology; Viruses; Young adults
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0217811

Sharing of injection drug use paraphernalia is a dyadic process linked to the transmission of HIV and hepatitis C virus (HCV). Despite this, limited research exists identifying specific dyadic interpersonal factors driving injecting partners' engagement in needle/syringe and ancillary injecting equipment sharing among young adults. Using semi-structured in-depth interview data collected between 2014 and 2015 from twenty-seven people who inject drugs (PWID), we applied an inductive approach to identify key injection drug-related interpersonal factors and developed a conceptual model integrating the findings based on interdependence theory. Interactions between injecting partners resulted in varying levels of injecting-related trust, cooperation, intimacy, and power. These factors interacted to collectively influence the type and level of risk perceived and enacted by injecting partners. The relationship between these injecting-related interpersonal factors, on the one hand, and risk perception on the other was dynamic and fluctuated between actions that protect the self (person-centered) and those that protect the partnership (partnership-centered). These findings indicate that the interpersonal context exerts substantial influence that shapes risk perception in all types of injecting partnerships. Partnership-focused prevention strategies should consider the dynamics of trust, cooperation, intimacy, and power, in characterizing dyadic risk perceptions and in understanding risky injecting practices among PWID.