Grant: CIHR Fellowship

The study proposes to ask 300 people who smoke drugs (PWSDs) about the members of their social networks that help or facilitate their personal harm reduction behaviors. As the name implies, the goal of harm reduction programs is to help decrease some of the adverse effects associated with drug use, as opposed to completely eradicating it. This would be the first study to map out the harm reduction social networks of PWSDs in the Downtown Eastside of Vancouver (DTES) and beyond. Social networks provide opportunities to understand the flow of infectious diseases, while providing insights into the at-risk behaviours of drug users, and simultaneously offering a means to map the transmission of safe practice behaviours amongst drug users. PWSDs increasingly face the risk of blood and air borne infections such as Human Immunodeficiency Virus (HIV), Hepatitis C (HCV) and Tuberculosis (TB) because of the constant sharing of drug paraphernalia such as pipes. This project aims to compare the structure of the networks of three recruiting sites: 1) Insite, North America's only supervised injection facility (SIF) that also provides safer crack pipe kits in the DTES; 2) VANDU, the peer-driven network of drug users established in the DTES that assembles and provides safer crack kits, and 3) Surrey, where few support harm reduction networks or programs are available for PWSDs. The working hypothesis is that the structure of the harm reduction peer driven network facilitates opportunities for education, counselling, detoxification and other preventative measures that lead to the reduction of risk factors for HIV, HCV and TB. More specifically this research using egocentric network of peers-which examine peer's immediate neighbors and associated interconnections-hypothesizes that peers' education/work in Vancouver's DTES is able to alter attitude, norms and perceived behavioural control of PWSDs as it pertains to risky drug using behavior such as pipe sharing and public drug use.