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

The Context of Risk:
Ethnographic Contributions to the
Study of Drug Use and HIV
Stephen K. Koester
INTRODUCTION
Ethnographic research has made significant contributions to the
understanding of how and why injection drug use can facilitate human
immunodeficiency virus (HIV) transmission. Ethnographic studies have
described drug users and their behavior and informed the design of
interventions that are culturally relevant and capable of reaching these
individuals (Wiebel 1988). In this chapter, the author briefly summarizes
ethnographic methods and illustrates how this research approach is
especially useful for providing research depth. In particular, the chapter
focuses on the contribution of ethnographic research to detailing the
meanings people attribute to their behavior and to identifying and
describing the contexts in which behavior is embedded.
Understanding how other people organize and make sense of their world
is the primary objective of ethnographic research. To accomplish this
objective, an ethnographer studies a group by experiencing its members
lives firsthand—interacting with them on their terms and in their
environment. This in-depth research method is called participant
observation and is at the heart of anthropological fieldwork. The
assumption behind participant observation is that much can be learned by
listening and observing a group’s members in their natural setting.
Conducting participant observation with a group over time enables
researchers to gain an insider perspective, enabling them to comprehend
both the cognitive and material reality of others (Agar 1980).
Ethnographers augment their ongoing observations with a variety of
interviewing techniques. These techniques are designed to solicit
information about ways of life and patterns of behavior that may appear
fundamentally different than their own. Interviewing techniques extend
from completely unstructured discussions to survey instruments.
However, since ethnography is most useful for exploring new areas of
inquiry and for providing depth rather than breadth, most ethnographic
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