Drug usersʹ sexual relationships and the social organisation of risk: The sexual relationship as a site of risk management

Research on “risk behaviour” in the time of AIDS has emphasised how social relationships influence individualsʹ responses to risk. Yet the social relationship remains an under-utilised unit of analysis in risk behaviour research. Drawing on qualitative research with illicit drug users in London, this paper illustrates how drug usersʹ sexual relationships act as key sites of risk management in individualsʹ drug use and everyday lifestyles. First, while recent research has almost exclusively focused on the dangers of disease transmission, our findings show that drug users perceived their sexual relationships as influencing a variety of risks associated with heroin and other opioid drugs. Here, two types of relationships—“gear” and “straight” relationships—were perceived to be particularly important. Second, while research has tended to focus on drug and health risks as an outcome of relationships, drug usersʹ accounts emphasise that managing risks to their relationships is an important facet of everyday risk management made complicated by drug use. It is argued that risk is a product of social interactions, and that the sexual relationship is an important site of risk management in this process. Future interventions should target drug usersʹ sexual relationships as agents of risk management and behaviour change.