Injectors and the inside : prisons, risk and HIV.

The spread of human immunodeficiency virus and other infection through drug injecting and sexual risk behaviour raises important considerations for social policy. The aims of this thesis are broadly two-fold. First, to explore and understand more about the influences on drug injectors' risk behaviour and how these influences might operate inside and outside prison. Second, to consider the impact of policy on drug injectors' lives and subsequent risk behaviour. To examine these issues a qualitative approach was adopted. Four research methods were used: in-depth interviews, a vignette, small group discussions and diary field notes. Drug injectors were contacted in the community and a total of 24 drug injectors with prison experience participated. The empirical component of the research was underpinned by the development of a new theoretical framework towards conceptualising risk behaviour. Inductive and deductive qualitative data analysis categorised perceptions of risk into three broad themes revolving around risky situations, influences on and mechanisms of risk reduction, and responses to risk behaviour. Drug injectors' views and experiences on three policy topics - the role and operation of prison drug and injecting equipment markets, mandatory drug testing, and substitute drug prescribing - were explored. This thesis raises important implications for the ways drug injectors' risk behaviour is understood and how policy responses can be better informed. Ultimately, there is a need for policies to reduce drug-related harm amongst drug injectors, especially when they spend time inside prison. That this is missing from current policy agendas results in people putting themselves and others at risk of infection