Working with drug users to prevent the spread of HIV: the application of an analytical framework to a range of programmes

Abstract

The rate of HIV infection amongst intravenous drug users is rising. A variety of programmes reflecting different pragmatic, ideological and political considerations have been implemented in response. Analytical frameworks are being devised to aid our understanding of such programmes. This paper focuses on one particular framework and applies it to a number of approaches in the field of HIV, AIDS and intravenous drug use. It suggests that analytical frameworks focusing on the mechanisms of intervention are useful in identifying important elements of programmes, but also have their own limitations. There are few examples of work with drug users which fit discrete categories and different philosophies and policies inevitably affect those working styles. The inherent tensions in reconciling the new discourse of harm-reduction with the old discourse of abstinence create confusion. and contradictions which need to be addressed in the evaluation and development of future programmes.