The Context of HIV Risk Among Drug Users and Their Sexual Partners

than two-thirds (67.8 percent) of the hustlers and nearly two-fifths
(38.9 percent) of call men reported having ever injected (table 2). Levels
of educational achievement were associated with injection drug use; men
who reported low levels of education more often reported injection drug
use than those with high levels. In the second sample, the percentage of
those reporting ever injecting drugs was even greater; nearly
three-quarters (74.8 percent) of the hustlers and more than half
(56.1 percent) of the call men had injected illicit drugs (table 3). In both
instances, the most frequently reported injected drugs were
methamphetamines, cocaine, and heroin.
Syringe Sharing and Problems Designing Questions To
Explore the Topic
In general, there were considerable problems formulating and asking
questions about syringe sharing. The surveys were limited by the amount
of time required to gather good quality data, the caution and reluctance
that many drug injectors feel about admitting unsafe injection practices,
and the variable ways that IDUs define sharing. These limitations all
became evident during the first study.
The initial wording for all syringe questions (32 questions in all) in the
first study was devised to include a simple screening question that, if
answered ‘yes,’ was followed by a series of questions that explored who
respondents shared with, occasions of sharing, and situations of sharing.
The screening question was worded as follows: “Have you ever shared
needles or syringes with any person? By needle sharing, we mean
sharing with anyone.” The codes for this answer were simple
enough-shared or not shared. And if a person said that he did not share,
then interviewers skipped the series of other sharing questions.
Before actual interviewing took place for the first study, the questions
were tested with 20 respondents. Some of the other sharing questions
were revised, but no problems were observed with the screening question.
After the first 90 interviews were completed, the results were reviewed
and investigators came to the conclusion that respondents were
underreporting syringe sharing. Underreporting was suspected because
of the sizeable proportion of injectors who never reported sharing.
Roughly 30 percent of those who reported drug injection also reported
that they had never shared, although some of these responses were from
men who reported injecting more than 1,000 times. In San Francisco,
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