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

Hopelessness is the rationale for Mark to continue using drugs. While
Rob’s explanation is different, similarly he was not motivated to protect
himself from HIV infection. Rob initially perceived himself as
invulnerable.
“Of course there were general things out and around (about AIDS),
you know, in the city or whatever, but not in the suburbs. I don’t
remember anything...It wasn’t a priority with me, and it never
became a priority with me...I don’t know why. I guess it never got
into my head that I could be infected....I had problems with
self-esteem. I didn’t care, for a long time. I didn’t care if I got
infected, it was like, what does it matter.”
Even if these adolescents were motivated to change their drug use and
sexual behaviors, most do not know what to do and how to change. In
fact, many say there were few prevention messages. For example, Jim’s
knowledge about HIV transmission upon arrival in San Francisco was
incomplete.
“I thought the only way to get AIDS was through anal sex. I thought
that as long as I didn’t do that, then I was cool!... I couldn’t figure
out why them outreach workers were passing bleach out on the
streets (laughs). Then I learned about bleach your needles, clean ‘em.
I figured my needle works just fine, I clean them with water...Within
a week or two, them outreach workers said don’t share needles,
you’ll get AIDS! I had already done a bunch of them things.”
Information is understood and acted upon slowly and over time in
informal settings and communities. Eventually, group norms and
subcultural practices have to be changed for consistent self-protective
behavior to occur. Rob, for example, would only use condoms if a
partner took the initiative, supplied them, and insisted that he put one on.
First and foremost, he wanted to please.
“There may have been very few times that I did (use a condom). I
mean, this is the Northwest, it (condom use) didn’t happen in the
Northwest, you know, it was like no one knew anyone that had ever
had HIV there...There wasn’t even really any prevention messages. I
went through sex education in high school and I never heard diddly
about it....it seemed to have been a far-off thing to me, you know...it
was not there.”
171