More than clean works?: an investigation of the role of a needle exchange in drug using behaviour

This study explores the role of a needle exchange service in the drug using behaviour of its clientele with a specific emphasis on sharing injecting equipment. Theoretical perspectives that have attempted to understand the role of needle exchange in changing drug using behaviour are critically reviewed and placed in the context of wider debates about approaches to changing drug using and health behaviour. Different perspectives can be broadly differentiated by the extent to which they focus on the individual and their beliefs or the social context including social interactions in which the. behaviour occurs. A definition of motivation is proposed as a potentially integrative concept in which a number of influences on behaviour can be considered and understood in tern-is of competing contingencies that moderate the potential for sharing injecting equipment over time both between and for individuals. A theoretical framework outlined by Derek Layer is also used to consider the literature reviewed in ternis of different levels of explanation. This enables the interrelations between Merent perspectives to be explored. This study is based on empirical research involving semi structured interviews with six clients and three staff of a needle exchange. It employs a grounded theory approach which identifies the importance of social support provided by the service in relation to self image and drug using behaviour. Further findings provide useful information about the nature of the local drug using network as well as the fiinction and quality of client / worker relationships In the service. These findings are considered using Layder's theoretical framework to explore interconnection and to reflect on aspects of clinical practice and implications for needle exchange service delivery