To date, little attention has been given to the potential role supervised injecting programs could play in the care for HIV-positive injection drug users (IDU). We analyzed semi-structured interviews with HIV-positive IDU and healthcare staff regarding a supervised injection program integrated in an HIV focused care facility. Participant and staff reports indic ated that the integrated supervised injection program promoted safer injection practices and influenced access to care by fostering more open relationships, facilitating engagement in safer injection education and improving the management of infections. Participants and staff viewed the program as facilitating the delivery of care through mediating overdose risks and reducing the need to punitively manage drug use onsite. For some participants, however, feelings of shame regarding their substance use complicated uptake of the program. Despite these concerns, our findings highlight the benefits of addressing HIV-positive IDUs’ drug use in the context of comprehensive models of healthcare.
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