The goal of this study was to explore the attitudes of people who inject drugs (PWID) and carry out risky practices, identifying underlying factors in their speech that sustain those attitudes. We proposed a qualitative research design with PWID focus groups (n = 34) and interviews with experts (n = 3). The interviews were recorded, transcribed, and analyzed following the principles of grounded theory and thematic analysis methodology. A total of 17 risk categories were identified and grouped into six dimensions: Drug Consumption, Knowledge, Trust In Other People, Access To Unused Syringues, Personal Situation, and Random. These dimensions would modulate the magnitude of the attitudes towards the different risky injection practices or act as barriers that limit the intention of PWID to inject themselves in a safe way. The analysis of the narratives suggests that many PWID have developed slightly negative, neutral, or even positive attitudes towards some risky injection practices, mainly towards carrying them out in certain situations and even when knowing of their negative consequences. Characterizing the attitudes associated with risky injection practices not only contributes to understanding them more thoroughly but will also allow preventive programs to be better suited to the specific needs of PWID.
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