A qualitative investigation into an HIV outbreak among injection drug users in Vancouver, British Columbia

The proportion of injection drug users (IDUs) testing positive for Human Immuno-deficiency Virus (HIV) in British Columbia has increased from 3 to 7% since January 1993 (Patrick et ar., 1997). We conducted a qualitative study as a first step in a case control investigation aimed at identifying risk factors associated with HN seroconversion. Sixteen subjects participated in in-depth interviews which were transcribed and analysed wing grounded theory methods. Three dominant themes emerged: Addiction, Prevention, and Social Determinants. The results suggest that prevention efforts such as the availability of clean needles and condoms ave not adequate to combat the complex social determinants of addiction-be they causal or consequential-which in turn contribute to unsafe injection practices.