Injectors and the inside : prisons, risk and HIV.

The spread of human immunodeficiency virus and other infection through drug injecting
and sexual risk behaviour raises important considerations for social policy. The aims of
this thesis are broadly two-fold. First, to explore and understand more about the influences
on drug injectors' risk behaviour and how these influences might operate inside and
outside prison. Second, to consider the impact of policy on drug injectors' lives and
subsequent risk behaviour.
To examine these issues a qualitative approach was adopted. Four research methods were
used: in-depth interviews, a vignette, small group discussions and diary field notes. Drug
injectors were contacted in the community and a total of 24 drug injectors with prison
experience participated. The empirical component of the research was underpinned by the
development of a new theoretical framework towards conceptualising risk behaviour.
Inductive and deductive qualitative data analysis categorised perceptions of risk into three
broad themes revolving around risky situations, influences on and mechanisms of risk
reduction, and responses to risk behaviour. Drug injectors' views and experiences on three
policy topics - the role and operation of prison drug and injecting equipment markets,
mandatory drug testing, and substitute drug prescribing - were explored. This thesis raises
important implications for the ways drug injectors' risk behaviour is understood and how
policy responses can be better informed. Ultimately, there is a need for policies to reduce
drug-related harm amongst drug injectors, especially when they spend time inside prison.
That this is missing from current policy agendas results in people putting themselves and
others at risk of infection.