Meanings of health for persons how inject drugs and living under highly precarious conditions
Introduction. Persons who inject drugs (PWID) and who are highly marginalized are, like all individuals, called upon to take responsibility for their own health. Method. This qualitative study, inspired by the theoretical framework of symbolic interactionism, sought to understand what health means for people who actively inject drugs. Twenty-six semi-structured individual interviews and two focus groups were conducted with 30 participants. The data was analyzed thematically. Results. While being almost synonymous with the capacity to live, for the participants, health is above all subjective and valued for what it brings to life. It is essentially a resource for functioning, for being autonomous and for achieving self-fulfillment, which also contributes to self-esteem. Participants claim to be responsible for their health and identify several behaviors, habits and attitudes that promote their health. However, demonstrating a broad perspective of health far beyond individualizing dimensions, participants also identified several determinants of health that relate to the environment, society and public policies. As a result, their perspectives point to the limits of health promotion through calls to be more responsible made to individuals and rather stress the importance of focusing on structural factors such as existing programs and policies, support and social solidarity. Conclusion. In addition to dispelling certain stereotypes, this study sheds light on the polysemic nature of health, as much as the ability to function, a state of well-being, a resource as well as a responsibility that can contribute to enhance the value of certain people who are healthy and while it can contribute to discriminate against others who have lost their health. These findings can help guide health and social interventions and programs for people who inject psychoactive substances.