Abstract

Health care workers in three AIDS hospital units in the Paris region were interviewed to analyse the issues related to the care of addicted HIV patients in the light of principles and practices regarding drug abuse treatment in France. Health care workers report a large variety of disruptive incidents involving some addicted in-patients. To deal with these difficulties, physicians advocate the separation of drug abuse treatment and HIV disease treatment. However, practices differ between the three settings regarding the management of patients. In two units, a contract is made with the patient covering general and specific rules of hospital stay and sanctions should the contract be broken. In the third unit, the use of such a contract is considered to be a continuation of drug abusers' stigmatization and an obstacle to the adoption of the ‘sick role’ by the addicted patient.