T Rhodes

Correspondence to: Dr T Rhodes, London School of Hygiene and Tropical Medicine, London, UK; tim.rhodes@lshtm.ac.uk

QUESTION

What is the lived experience of injecting drugs in public places and the social and structural factors that affect access to syringe distribution services?

DESIGN

Qualitative study.

SETTING

6 urban, semi-rural, and rural areas in south Wales, UK.

PARTICIPANTS

A purposive sample of 49 people (age range 18–47 y, 69% men) who were current injecting drug users (had injected drugs in the past 4 wks; mean duration 7.2 y).

METHODS

49 individual semi-structured interviews were held, each lasting 30–90 minutes. Topics included injecting equipment use, access, and availability; injecting locations; and health and service needs and experiences. Interviews were tape recorded, transcribed verbatim, and analysed from a perspective of interpretive critical realism.

MAIN FINDINGS

Public injecting. Participants described public injecting as a situational need rather than a choice. Injecting was viewed as a private behaviour, preferably done in non-public environments, which were also associated with cleanliness. Situational factors leading to public injecting were opportunity (“If I’m out, and they say ‘Oh …