Positive health beliefs and behaviours in the midst of difficult lives: Women who inject drugs

Abstract

Background: It is assumed that people who inject drugs (PWID) care little about their health. This emerges from social and moral perceptions of PWID and is framed by research that focuses on their morbidity and mortality. Drawing on the narratives of Australian women who inject drugs, we examined the salience of health for our participants and the contexts that structure their descriptions of health and wellbeing. Methods: We conducted qualitative interviews with 83 women who inject drugs and live with hepatitis C virus (HCV) to explore their experiences of health and health care seeking. Findings: Although the interviews focused on HCV, women discussed their health within broader contexts of drug dependence, unstable housing, unemployment, financial strain, other health issues and relationships. Concern about HCV was less pronounced than concerns about other health problems and socio-economic circumstances. Broadening the focus of health beyond drug use alone, women's narratives strongly suggest that PWID can and do care about their health. Conclusions: Whilst research and policy often focus on health problems and barriers to health amongst PWID, the women in our sample maintained positive health beliefs and behaviours. Much like other members of society, their health priorities are contextualised by cultural, economic and political factors. This suggests that health interventions aimed at women who inject drugs could build upon the salience of a range of health priorities as well as integrating these with structural interventions designed to improve housing and economic status.