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

interviews are designed to promote discussion. The subjects are
encouraged to “tell their story,” to describe their world and explain their
behavior. As a result, ethnographic interviews employ open, contrasted
to closed, questions. Combining participant observation with
ethnographic interviews and conducting both over an extended period of
time enable the ethnographer to identify and describe patterns of behavior
as well as the factors influencing behavior.
Two recent examples of in-depth ethnographic research pertinent to this
discussion are Eli Anderson’s book “Streetwise” (1990) and Philippe
Bourgois’ forthcoming study of a neighborhood crack scene in Spanish
Harlem (Bourgois, unpublished observations). Anderson details
changing economic and social relations in a Philadelphia community, and
Bourgois describes how local residents resist the limited economic
options open to them in the formal economy by participating in the
underground crack trade, a process of resistance that culminates in a
culture of terror. Both of these researchers lived with the people they
studied and participated in their daily lives.
In many cases, current ethnographic research on HIV and drug use does
not achieve the degree of researcher involvement illustrated by these two
studies. Much drug and acquired immunodeficiency syndrome
(AIDS)-related research is “applied,” meaning that it is oriented toward
solving or contributing to the solution of a particular problem rather than
providing a comprehensive study of a particular group or culture.
Nonetheless, applied researchers share the same perspective and methods.
Applying the ethnographic perspective and its accompanying research
methods to the study of high-risk activity among drug users has resulted
in a much more intimate and holistic understanding of drug users and
their behavior. It has uncovered the meanings drug users attach to their
behavior and has led to a greater understanding of the complex set of
factors that influence their lives.
THE MEANING OF RISK
Even when social groups are part of a larger social and cultural system,
their specific experiences and circumstances may result in differences in
meaning or perspective. It is essential to identify and comprehend such
differences to understand drug users and the risks they take. For
example, needle cleaning is a term public health researchers would
assume refers to a hygienic procedure for disinfecting a needle. This
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