Injecting drug use, risk behaviour and risk environment in Hungary: A qualitative analysis

There is an absence of qualitative research investigating risk behaviour and risk environments associated with the transmission of blood-borne viruses (BBVs) among injecting drug users (IDUs) in Hungary. Qualitative interviews were conducted with 33 IDUs who had injected at least once during last 30 days. Participants were residents of Budapest and Pécs, mostly aged 22-25 years, and comprised 22 men and 11 women. The interviews focused on the preparation and division of drug solution and on the shared use of needles and syringes and other injecting paraphernalia, as well as the physical, social, economic and policy components of the injecting micro-environment. Interviews were analysed using Atlas.ti computer software. Findings identified that the division of the drug solution between injectors typically involved the shared use of cooking equipment, filters and water containers. Collective preparation was often followed by shared needle and syringe use. Withdrawal symptoms were perceived to increase the likelihood of such risky behaviour. This study highlights BBV risks arising from the micro-risk environment of injecting drug use, and emphasises the importance of setting and context in harm reduction interventions.