Understanding the Reasons for Sharing Syringes or Needles to Inject Drugs: Conventional Content Analysis

Abstract

Background: This qualitative study was undertaken with the aim to identify the reasons for sharing syringesor needles among people who inject drugs (PWID) in Iran.Methods: We used purposive sampling to recruit 4 groups of participants, male PWID (n = 14), female PWID(n = 6), service providers (n = 8), and human immunodeficiency virus (HIV)/addiction experts (n = 9). Datawere collected through 2 focus group discussions (FGDs) among male PWID, and semi-structured interviewswith female PWID, service providers, and HIV/addiction experts. Using conventional content analysis,themes were extracted for reasons for sharing needles to inject drugs.Findings: We found 13 themes for barriers such as low perceived risk of HIV, high stigma around druginjection and use, low access to harm reduction education and prevention services due to their limitedworking hours as a well as uneven geographical distribution of services, some structural barriers likeincarceration, poverty, and homelessness, and several competing survival needs beyond the injection-relatedsafe behaviors.Conclusion: Our study was able to provide the perspectives of both PWID and health care authorities andproviders towards several barriers to accessing HIV prevention services that lead to needle sharing amongPWID in Iran. These barriers need to be addressed to achieve the target of HIV epidemic control.

Keywords

• drug users
• needle sharing
• qualitative research