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Risky injecting practices associated with snowballing: a qualitative study.

Louise Wilkins1, Paul Bissell, Petra S Meier

  • 1School of Health and Related Research, University of Sheffield, Sheffield, UK. louise.wilkins@nottinghamcity.nhs.uk

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Snowballing, or co-injecting heroin and crack cocaine, is a communal activity influencing peer injection practices. Understanding users' perceptions of "sharing" and "splitting" is crucial for effective harm reduction strategies.

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Area of Science:

  • Public Health
  • Addiction Studies
  • Sociology

Background:

  • Crack cocaine injecting is linked to increased sharing, hepatitis C, and homelessness.
  • Snowballing (co-injecting heroin and crack cocaine) may increase risky injection practices.
  • Limited evidence exists on the specific behaviors and perceptions associated with snowballing.

Purpose of the Study:

  • To explore the views and experiences of individuals who engage in snowballing.
  • To inform improvements in harm reduction services for this population.
  • To understand the social dynamics influencing injection practices in communal drug use.

Main Methods:

  • Qualitative interview study design.
  • In-depth interviews with 18 homeless drug users (male and female).
  • Participants recruited from a needle exchange service in Nottingham, UK.

Main Results:

  • Snowballing was perceived as a communal activity impacting peer injection practices.
  • Individual interpretations of 'sharing' and 'splitting' influenced risk perception.
  • Knowledge of partners' vaccination and screening history is important for managing communal drug use risks.

Conclusions:

  • Harm reduction services must tailor information for communal drug use.
  • Interventions should address the social context and user perceptions of risk.
  • Effective strategies require understanding the nuances of shared injecting practices.