Sustained Needle Sharing among Clinic-based Southern Thai Intravenous Drug Users

Abstract

This study was aimed to explore perceptions, knowledge, and attitudes towards needle sharing among clinic-based intravenous drug users (IDUs) at a drug-treatment clinic in Songkhla province, southern Thailand. Qualitative methods were used to gather data, including: in-depth interviewing with 17 active IDUs; in-depth interviews with 3 health care providers; participant observation; reviewing IDUs' file documents; validation after interview completion to ensure data triangulation. A comparative content analysis was used for data analysis. After 15 years of the Thai HIV/AIDS epidemic, most southern IDUs still engaged in needle sharing although reported reductions in sharing frequency. Withdrawal symptoms and craving were most commonly cited as compelling reasons to share. Lack of syringe availability when needed, and misconceptions about how to determine the “healthy” versus "sick” were major factors underlying sharing. Receiving HIV voluntary counseling and testing (VCT) and knowing test results, however, promotes sharing reduction. The findings suggest that southern Thai IDUs remain at high risk of acquiring HIV infection, primarily through needle sharing. Harm reduction strategies, such as, providing VCT to all IDUs, promoting needle exchange programs, and providing access to health care services might be beneficial approach to curb the rapid spread of HIV infection among IDUs and their sexual partners in the future.