Drug user networks, coping strategies and HIV prevention in the community

Qualitative data from England illustrate the way coping strategies form an integral part of the everyday lifestyles of injectors of illicit drugs. Ethnographic investigation of social networks and the rules which underpin them is crucial in devising appropriate community-based interventions. Such networks are characterized by functional and reciprocal relations. Peer education and health advocacy takes place on an informal basis. Key figures who adopt these roles should be encouraged to act as Indigenous Advocates as part of interventions which place drug users and their everyday lives at the core. Rules and social etiquettes of networks are not always positive for the public health agenda, as illustrated by the sharing of injecting paraphernalia and the injecting taboo among the Afro-Caribbean community. Ethnographic study can pinpoint foci for intervention. Harm minimization needs to be promoted using all the resources available, including the informal protective strategies of drug users and outreach interventions aimed at specific issues and targeted toward particular groups.