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Maintaining the healthy body: Blood management and hepatitis C prevention among men who inject performance and image-enhancing drugs

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journal contribution
posted on 28.02.2021, 23:48 authored by Renae FomiattiRenae Fomiatti, Emily LentonEmily Lenton, Joe LathamJoe Latham, Suzanne FraserSuzanne Fraser, David MooreDavid Moore, Kathryn SeearKathryn Seear, Campbell Aitken
© 2019 Australia's ambitious aim to ‘eliminate’ hepatitis C as a public health concern by 2030 requires researchers, policy makers and health practitioners to engage with populations rarely identified as a priority. Men who inject performance and image-enhancing drugs (PIEDs) are one such population, yet research suggests they have low rates of knowledge about hepatitis C. Although rates of needle-sharing in this group are thought to be low, other risks of blood-to-blood contact exist due to the use of large-gauge needles, intramuscular injecting, hard-to-reach injection sites, repeated injecting and peer-to-peer injecting. How should health initiatives engage people who might not customarily consider themselves vulnerable to hepatitis C? Drawing on the work of body theorist Margrit Shildrick, this article considers how men who inject PIEDs understand their bodies, with a particular focus on injecting practices, blood awareness and infection control, in order to inform hepatitis C prevention efforts. In our analysis, we draw on qualitative interviews with 60 men who inject PIEDs, which we conducted for an Australian Research Council-funded project focused on better understanding PIED injecting to improve health and minimise hepatitis C transmission. The interviews suggest that men who inject PIEDs closely monitor potential external infection risks, such as dirt and bacteria that might intrude upon the ‘purity and security’ of the body. However, less attention appears to be paid to what might be transferred out of the body and potentially to others, such as blood. Notions of trust and cleanliness, and normative perceptions of intravenous drug use, also shaped injecting practices and cursory attention to blood management. While environmental transmission poses a smaller transmission risk than needle-sharing, educating PIED consumers about it is nevertheless warranted. Focusing targeted health promotion materials on environmental blood as a potential route of hepatitis C transmission may help engage this population in prevention, and encourage more frequent hepatitis C testing.


The research reported in this paper was funded by the Australian Research Council (Discovery Project DP170100302) and conducted at the Australian Research Centre in Sex, Health and Society, La Trobe University and the National Drug Research Institute, Curtin University. The National Drug Research Institute is supported by core funding from the Australian Government under the Drug and Alcohol Program and also receives significant funding from Curtin University. Kate Seear is funded by an Australian Research Council DECRA Fellowship (DE160100134).


Publication Date



International Journal of Drug Policy



Article Number



9p. (p. 1-9)





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