“It’s Not Only My Life I Got to Worry About”: Accounts of Needle-Syringe Sharing and Negotiated Safety among Couples who Inject Drugs

Author: Rance J, Treloar C, Rhodes T, Bryant J, Fraser S

Theme: Social Science & Policy Research Year: 2015

The intimate partnerships of people who inject drugs function as crucial sources of care, support and stability and influential sources of practice – including those negotiated around drug use – yet have been largely overlooked in the literature. Borrowing and refashioning the concept of ‘negotiated safety’ from its origins in gay men’s HIV-prevention practice, we examine how our participants endeavoured to co-create meaningful practices of care and safety – including those concerned with navigating and maintaining intimacy as well as viral management – in response to their lived contexts.

We draw on 34 interviews conducted with heterosexual couples who inject drugs as part as of a broader qualitative research project examining the understanding and prevention of hepatitis C transmission within sexual partnerships. We explore a key theme emerging from the data: the sharing of needle-syringes between intimate partners.

For couples who inject drugs, negotiating safety is a complex, and at times contradictory process, involving the balancing or prioritising of multifarious, often competing, risks. For all our participants, negotiating safety required balancing the emotional dimensions of partnership alongside its pragmatic functions. The day-to-day management of risk and the negotiation of safety need to be understood as not merely occurring within partnerships, but as actively doing or enacting them.

While the concept of ‘negotiated safety’ has been well utilized within the HIV literature regarding men who have sex with men, it has rarely been explored within the field of illicit drug use and hepatitis C. In our continued efforts to understand and prevent the transmission of hepatitis C, as well as address the dynamics of social exclusion, we need to better recognise and work with the sources of intimate knowledge, trust and negotiated safety that lie within the partnerships of those inject drugs, as well as identifying the viral risks.

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