Self-Reported Reasons for Needle Sharing and Not Carrying Bleach among Injection Drug Users in Baltimore, Maryland

Stated reasons for sharing needles and not intending to carry bleach for 413 injection drug users in the Stop AIDS for Everyone (SAFE) study in Baltimore, Maryland, were analyzed. Over two-thirds (69%) reported they knew individuals who had “gotten in trouble” by police for carrying needles. Of the injection drug users, 38% stated the main reason they shared needles without cleaning them first with bleach was a sense of time urgency, and 30% reported that clean needles were not available. The most common reason given by 24% of the participants for not intending to carry bleach was that they inject at home where bleach is available. Another frequently mentioned reason for not intending to carry bleach was wanting to stop using drugs. These results have implications for HIV prevention and suggest the importance of preventive interventions that emphasize drug users' planning where and when they will inject drugs. The findings also suggest that needle sharing may be in part an unintended consequence of Maryland's current drug paraphernalia laws.