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

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TABLE 3. Injection Drug Use by Type of Sex Worker--Latest Sample (N = 552) 1989-1991 Injection Drug Use Ever Injected Drugs Number of Times Injected* 1-10 11-250 250-1,000 > 1,000 Drug Injected. Methamphetamine Cocaine Heroin Number of Times Injected Last Week Zero 1-5 6 or more Shared Syringe The First Time Injected* Ever Used a Used Syringe Without Cleaning It Interviewed in Previous Study Type of Sex Worker Hustlers Call Men (N = 226) (N = 326) 169 74.8% 23 13.6% 33 19.5% 21 12.4% 92 54.4% 157 92.9% 110 65.1% 110 65.1% 62 36.7% 51 30.2% 56 33.1% 97 57.4% 97 57.4% 17 7.5% Total (N = 552) 183 56.1% 352 63.8% 51 27.9% 28 15.3% 26 14.2% 78 42.6% 159 86.9% 94 51.4% 93 50.8% 118 64.4% 47 25.6% 18 9.8% 101 55.2% 96 52.5% 74 21.0% 61 17.3% 47 13.4% 170 48.3% 316 89.8% 204 58.0% 203 57.7% 180 51.1% 98 27.8% 74 21.0% 198 56.3% 193 54.8% 27 8.3% 44 8.0% * Of those sex workers who reported ever injecting drugs. ** Of the total number of sex workers. 125
By the 100th interview, the screening question was revised to open up the answers. The revised questions were: “Tell me about the first time you ever injected any illicit drugs. How did you get the needle or syringe to inject the drug?” “For how long did you ever use other people’s syringes or works?” “How many people did you share a syringe with?” “Did you ever share needles with anyone else after the first time?” At the conclusion of the remaining 260 interviews, the same kinds of disparities were found as in the first 100: roughly 30 percent who reported injection stated that they had never shared. In other words, the revised wording did not elicit any better responses than the simple screening question had. The investigator decided to simply take people at their word and used two codes for the question: shared or did not share. However, the investigator was suspicious of these reports and believes that a sizeable number of the respondents underreported sharing. Despite these problems, the study found that there was considerable sharing and a good deal of it took place in communal settings such as shooting galleries, sex clubs, and bath houses. More than 7 out of 10 (79.4 percent) of 192 injectors from the first sample reported sharing syringes. Syringe sharing occurred among a variety of relationships and social situations: with friends, roommates, and intimates and in communal settings such as shooting galleries, sex clubs, and bath houses. More than 3 out of 10 (30.2 percent) of those who had shared syringes reported sharing in shooting galleries, and a sixth (15.1 percent) reported sharing in bath houses and sex clubs. (Refer to Waldorf et al. 1990 and Waldorf and Murphy 1990 for more detailed findings.) For the second survey, which focused primarily on condom use but also asked about drug injection, the syringe-sharing questions were redesigned and consolidated into two questions. Here is how the questions were worded: “Tell me about the first time you ever injected any drug. Did you have your own syringe, or did you use someone else’s?” “Have you ever been forced by circumstances to use a needle that someone else had used previously without cleaning it with bleach?” This revision produced the following results for the second survey: nearly two-thirds of the sample reported injecting drugs (63.8 percent), and only 56.3 percent of injectors reported that they shared syringes the first time they injected. Roughly half (54.8 percent) reported that they had used another person’s syringe without cleaning it with bleach. 126
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National Institute on Drug Abuse RE
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ACKNOWLEDGMENT This monograph is ba
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Drug Use and HIV Risk Among Male Se
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Partners. The review was held April
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Inciardi, J.A.; Lockwood, D.; and P
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highlights the critical importance
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AUTHOR Richard H. Needle, Ph.D., M.
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Blower and colleagues (1991) have p
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Even in areas with low seroprevalen
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involves using a syringe to draw bl
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Hispanics were less likely to repor
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victimization through theft, violen
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sharing? When are needles deliberat
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Chitwood, D.D.; McCoy, C.B.; Inciar
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Page, J.B.; Smith, P.C.; and Kane,
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HIV/AIDS Risks Among Male, Heterose
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during that time, and the possibili
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All of these issues and considerati
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ecoming the norm for both male and
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the skin on his penis while having
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REFERENCES Ball, J.C., and Chambers
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Johnson, A.M.; Petherick, A.; David
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Vogt, M.W.; Craven, D.E.; Crawford,
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transmission from males to females
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(this volume), there is little atte
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Clayton, R.; Voss, H.; Robbins, C.;
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Female Drug Abusers and the Context
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have the data but interpret it supe
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important to examine current studie
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found in this study was low socioec
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who trade sex for crack; and simila
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esponsibilities in perspective. Suc
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Robles and colleagues (1990) examin
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The lack of rational thought separa
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Factors Associated With Sexual Risk
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Factors Associated With Poverty A n
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encouraging such women to leave the
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Hispanic women but extramarital aff
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coherence—the sense that life is
Page 79 and 80: the change agent may be a crucial f
Page 81 and 82: Centers for Disease Control and Pre
Page 83 and 84: Jemmott, J.B.; Jemmott, L.S.; Spear
Page 85 and 86: O’Leary, A.; Celentano, D.; Maiba
Page 87 and 88: Drug Use and HIV Risk Among Gay and
Page 89 and 90: with 34.6 percent of gay men and 28
Page 91 and 92: found among both hustlers and call
Page 93 and 94: Substance Use and HIV-Transmitting
Page 95 and 96: TABLE 1. Prevalence of substance us
Page 97 and 98: less than 2 percent of participants
Page 99 and 100: TABLE 2. Quantity of alcohol use am
Page 101 and 102: A fourth study of gay/bisexual men,
Page 103 and 104: in mind, however, that most of the
Page 105 and 106: seropositivity and reported NMPD us
Page 107 and 108: interaction and education than men
Page 109 and 110: Geographic differences found in the
Page 111 and 112: that they are intending or desirous
Page 113 and 114: enough is known in general about th
Page 115 and 116: REFERENCES Calzavara, L.M.; Coates,
Page 117 and 118: Ostrow, D.G.; Beltran, E.; Chmiel,
Page 119 and 120: Drug Use and HIV Risk Among Male Se
Page 121 and 122: prostitutes were HIV positive, as c
Page 123 and 124: Trade hustlers are usually heterose
Page 125 and 126: TABLE 1. Number of Completed Interv
Page 127 and 128: diagnosed slightly more often than
Page 129: TABLE 2. Injection Drug Use by Type
Page 133 and 134: SUMMARY AND CONCLUSIONS In general,
Page 135 and 136: Plant, M. Sex work, alcohol, drugs
Page 137 and 138: HIV Risk in Drug-Using Adolescents
Page 139 and 140: AUTHOR Vincent L. Smeriglio, Ph.D.
Page 141 and 142: comprise 23 percent of all adolesce
Page 143 and 144: 232 (18 percent) of the cases; and
Page 145 and 146: Although these data provide an over
Page 147 and 148: Most of these were unprotected sexu
Page 149 and 150: national epidemiologic survey of hi
Page 151 and 152: Hawkins et al. 1992; Newcomb et al.
Page 153 and 154: higher rates of HIV/AIDS in adolesc
Page 155 and 156: Boyer, C.B. Psychosocial, behaviora
Page 157 and 158: Irwin, C.E., Jr., and Shafer, M.A.
Page 159 and 160: Zweig Greenberg, MS.; Singh, T.; Ht
Page 161 and 162: the types of intervention strategie
Page 163 and 164: from a study group of 52 youths who
Page 165 and 166: forearm during a sexual episode. At
Page 167 and 168: I was nice looking, like I can do a
Page 169 and 170: It is unclear whether the disinhibi
Page 171 and 172: continual sexual dysfunction was re
Page 173 and 174: TWEAKING, FREAKING, AND OVER-AMPING
Page 175 and 176: highway of love. It’s like, I’d
Page 177 and 178: Unprotected sexual activity is more
Page 179 and 180: alternatives and opportunities, and
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the night and food for the morning.
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7. also can help youths explore and
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Jessor, R., and Jessor, S.L. Proble
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AUTHORS Mary Jane Rotheram-Borus, P
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Brunswick goes on to discuss the le
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permission-giving introductions to
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conversion and perhaps even serocon
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TABLE 1. Ecological paradigm of con
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TECHNICAL ISSUES Technical issues i
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eliability. It seems obvious that q
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sometimes as many as three zip code
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Resources and effort are required t
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Brunswick, A.F.; Lewis, C.S.; and M
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The Context of Risk: Ethnographic C
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same meaning may be extended to dru
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THE CONTEXT OF RISK Context is an a
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hurried, and adequate needle cleani
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degrading sexual acts, poignantly m
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searched me and I had stashed the c
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REFERENCES Agar, M. The Professiona
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Ouellet, L. J.; Jimenez, A.D.; John
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Assessing the Reliability and Valid
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TABLE 1. Sociodemographic profile o
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Table 2 shows percentage agreement
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FORENSIC TECHNIQUES TO DOCUMENT SEL
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cross-tabulated with dichotomous me
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TABLE 6. Relationship of question t
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aggravate self-presentation bias. T
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TABLE 8. Percent of subjects report
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intercourse, and since anal interco
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Future Directions for Studies on th
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abusers, and other variables are ne
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Behavior patterns can be clarified
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As Des Jarlais noted, designs and a
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strengths within a setting or indiv
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National Institute on While limited
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62 NEUROSCIENCE METHODS IN DRUG ABU
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89 BIOLOGICAL VULNERABILITY TO DRUG
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111 MOLECULAR APPROACHES TO DRUG AB
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127 PROGRESS AND ISSUES IN CASE MAN
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NIH Publication No. 94-3750 Printed
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The Context of HIV Risk Among Drug Users and Their Sexual Partners

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