Drug use involves social interactions. Therefore, norms in the proximal environment of people who inject drugs (PWID) can favor behaviors that may result in HIV transmission. This work aimed at studying drug injection-related norms and their potential association with risky behaviors among PWID in Athens, Greece, in the context of economic recession and political activism that followed the fiscal crisis and soon after a recent HIV outbreak had leveled off. The Transmission Reduction Intervention Project (TRIP) was a social network-based approach (June 2013 to July 2015) that involved two groups of PWID seeds—with recent HIV infection and with long-term HIV infection and one control group of HIV-negative PWID. Network contacts of seeds were also enrolled. TRIP participants answered a questionnaire that included items on injection-related norms and behaviors. TRIP recruited 320 PWID (HIV positive, 44.4%). TRIP participants, especially those without HIV, often recalled or perceived as normative among their partners and in their networks some behaviors that can lead to HIV transmission. TRIP participants who recalled that they were encouraged by their regular drug partners to use an unclean syringe were almost twice as likely to report that they share syringes [odds ratio (OR) = 2.03; 95% confidence interval (CI) = 1.86–2.21], or give syringes to someone else (OR = 1.70; 95% CI = 1.42–2.04) as those who did not recall such an encouragement. Associations were modified by HIV status. HIV negatives, who were reportedly encouraged to share nonsyringe injecting equipment, were almost 4.5 times as likely to share that material as HIV-negative participants who were not encouraged (OR = 4.59, 95% CI = 4.12–5.11). Further research is needed on the multiple determinants (social, economic, and political) of norms in the social environments of PWID. Since peer norms are associated with risky behaviors, interventions should be developed to encourage norms and peer pressure against the sharing of injection equipment.

中文翻译：

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希腊雅典吸毒者的吸毒相关规范和高危行为

吸毒涉及社会互动。因此，注射吸毒者 (PWID) 附近环境中的规范可能有利于可能导致 HIV 传播的行为。这项工作旨在研究与注射毒品相关的规范及其与希腊雅典 PWID 危险行为的潜在关联，这是在经济衰退和财政危机之后以及最近的 HIV 爆发趋于平稳后不久的政治激进主义的背景下进行的。减少传播干预项目 (TRIP) 是一种基于社交网络的方法（2013 年 6 月至 2015 年 7 月），涉及两组 PWID 种子——近期 HIV 感染和长期 HIV 感染，以及一个 HIV 阴性 PWID 对照组. 种子的网络联系人也被登记。TRIP 参与者回答了一份问卷，其中包括有关注射相关规范和行为的项目。TRIP 招募了 320 名 PWID（艾滋病毒阳性，44.4%）。TRIP 参与者，尤其是那些没有 HIV 的参与者，经常回忆起或认为在他们的合作伙伴和他们的网络中一些可能导致 HIV 传播的行为是规范的。回忆起他们的常规药物合作伙伴鼓励他们使用不干净的注射器的 TRIP 参与者报告说他们共用注射器的可能性几乎是两倍 [优势比 (OR) = 2.03; 95% 置信区间 (CI) = 1.86–2.21]，或将注射器给其他人（OR = 1.70；95% CI = 1.42–2.04）作为那些不记得这种鼓励的人。协会因艾滋病毒状况而改变。据报道，被鼓励共享非注射器注射设备的艾滋病毒阴性者接近 4 人。分享该材料的可能性是不鼓励的 HIV 阴性参与者的 5 倍（OR = 4.59，95% CI = 4.12–5.11）。需要进一步研究 PWID 社会环境中规范的多重决定因素（社会、经济和政治）。由于同伴规范与危险行为相关，因此应制定干预措施以鼓励规范和同伴压力反对共享注射设备。