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

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for example, 3.7 per 1,000 in a sample of 13- to 19-year-olds receiving ambulatory health services in a Washington, D.C., hospital (D’Angelo et al. 1991), and 53 per 1,000 in a high-risk group of 15- to 20-year-olds who were clients at a facility for runaway and homeless youth in New York City (Stricof et al. 1991). Gender, racial, ethnic, and geographic comparisons in infection rates have been provided in numerous reports (e.g., Bowler et al. 1992). Boyer and Ellen (this volume) review and discuss adolescent risk-taking behaviors and adolescent developmental processes as they may relate to HIV infection risk. They consider specific behavioral risk factors (e.g., age at onset of sexual activity and use of alcohol and other drugs) and possible antecedents of some of these behaviors (e.g., personality, school, and family factors). Rotheram-Borus and colleagues (this volume), following a discussion of developmental changes and challenges in adolescence, focus on high-risk adolescents. By examining case studies developed during ethnographic research, these authors provide indepth analyses of the context of HIV risk behaviors, routes into a specific drug-using subculture, and life patterns while using illicit drugs (i.e., methamphetamine). Rotheram-Borus and colleagues then make suggestions for intervention strategies to help adolescents cease or modulate drug-related activities, reduce HIV risk behaviors, and continue the identity search that is interrupted by contact with the methamphetamine subculture. REFERENCES Bowler, S.; Sheon, A.R.; D’Angelo, L.J.; and Vermund, S.H. HIV and AIDS among adolescents in the United States: Increasing risk in the 1990’s. J Adolesc 15:345-371, 1992. Centers for Disease Control and Prevention. HIV/AIDS Surveillance. Second Quarter Edition. Atlanta: Centers for Disease Control and Prevention, 1993. D’Angelo, L.J.; Getson, P.R.; Luban, N.L.C.; and Gayle, H.D. Human immunodeficiency virus infection in urban adolescents: Can we predict who is at risk? Pediatrics 88:982-986, 1991. DiClemente, R.J., ed. Adolescents and AIDS: A generation in jeopardy. Newbury Park, CA: Sage, 1992. Stricof, R.L.; Kennedy, J.T.; Nattell, T.C.; Weisfuse, I.B.; and Novick, L.F. HIV seroprevalence in a facility for runaway and homeless adolescents. Supplement. Am J Public Health 81:50-53, 1991. 133
AUTHOR Vincent L. Smeriglio, Ph.D. Health Scientist Administrator Clinical Medicine Branch Division of Clinical Research National Institute on Drug Abuse Parklawn Building, Room 11A-33 5600 Fishers Lane Rockville, MD 20857 134
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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
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the change agent may be a crucial f
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Centers for Disease Control and Pre
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Jemmott, J.B.; Jemmott, L.S.; Spear
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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 and 130: TABLE 2. Injection Drug Use by Type
Page 131 and 132: By the 100th interview, the screeni
Page 133 and 134: SUMMARY AND CONCLUSIONS In general,
Page 135 and 136: Plant, M. Sex work, alcohol, drugs
Page 137: HIV Risk in Drug-Using Adolescents
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
Page 181 and 182: the night and food for the morning.
Page 183 and 184: 7. also can help youths explore and
Page 185 and 186: Jessor, R., and Jessor, S.L. Proble
Page 187 and 188: AUTHORS Mary Jane Rotheram-Borus, P
Page 189 and 190:
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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