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

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after they shoot drugs. Thus, the same water is used for rinsing of syringes and mixing of drugs. Reports that the use of shooting galleries is associated with exposure to HIV infection are consistent in the literature. Murphy and Waldorf (1991) have described shooting galleries that provide a relatively private place to inject drugs, provide syringes for rent, and offer other materials to prepare the drugs for injection—such as water, cotton, matches, bottle caps, and syringes for sale. While Des Jarlais and Friedman (1987) described shooting galleries as an integral part of the addict lifestyle in New York, Murphy and Waldorf described shooting galleries as integral for impoverished addicts in the San Francisco Bay area. Shared injection equipment can transmit HIV when residual contaminated blood remains in previously used syringes and needles. Blood residue is often present in the syringe because of aspiration of venous blood into the syringe. Chitwood and colleagues (1990) reported that shooting gallery syringes that contain visible blood and those that appear visibly clean have a significant risk of carrying HIV. Ten percent of the needlesyringe combinations that were tested from three shooting galleries in South Florida were positive for antibodies to HIV type 1 (HIV-1). Data from this study suggest that the selection of visibly clean injection equipment does not eliminate the possibility of using an HIV-infected needle. Heterosexual IDUs appear to be less likely to engage in persistent shooting gallery use as compared with homosexual and bisexual men. Celentano and colleagues (1991) reported that in a sample of 2,615 active IDUs in Baltimore, lifetime shooting gallery use was associated with heavier drug involvement and with being male, homosexual or bisexual, of low socioeconomic status, and African American. The understanding of race/ethnicity as a predictor of HIV risk behavior is still in very early stages. Koblin and colleagues (1990) examined differences in HIV seroprevalence and patterns of drug use and sexual behaviors among Hispanic, African-American, and white IDUs in a sample recruited at multiple sites in Worcester, Massachusetts. After adjustment for demographic differences, African-American males were significantly less likely to report risky drug use behaviors (such as ever sharing needles and recently visiting shooting galleries) compared with white males. However, Hispanic males were significantly more likely to report recent risky drug use behaviors. Both African Americans and 15
Hispanics were less likely to report risky sexual behaviors compared with whites. Odds ratios for HIV seropositivity were significantly higher for Hispanics compared with whites and maintained marginal significance for African Americans compared with whites when adjusted for risk behaviors and demographic variables. These results, indicating variations in risk behaviors across race/ethnicity groups, are supported by other studies. Guydish and colleagues (1990) reported that African-American IDUs in a San Francisco sample were less likely to share needles than whites. Studies of HIV prevalence among IDUs have demonstrated varying racial/ethnic patterns dependent on the geographic area and subpopulation sampled. It is likely that risk behaviors also vary by geographic area and subpopulation. The finding that Hispanics and non- Hispanic African Americans in the United States share a disproportionate burden of HIV infection is perhaps due to the earlier onset of the HIV epidemic in African-American and Hispanic IDU populations. That is, while risk behaviors observed across race/ethnicity groups may be comparable, the increased probability of contact with an infected person may be an independent risk factor for African Americans and Hispanics. Behavioral, cultural, and socioeconomic differences within racial/ethnic groups need to be examined in further studies. Serrano (1990) has described Puerto Rican IDUs. The impact of HIV at the neighborhood level is described as devastating. Preventing AIDS within minorities is proposed within the context of several well-defined communities, such as the family, and entails the development of community resources to deal with many complex problems. Marin (1990) described non-Puerto Rican Hispanics and AIDS prevention efforts that use culturally appropriate interventions. SEXUAL RISK BEHAVIORS Feucht and colleagues (1990) described the sexual behavior of IDUs. Most male IDUs are sexually active and heterosexual, and significant proportions have multiple female partners. In this sample, while white males were about as likely to have an IDU partner as a non-IDU partner, only a third of the African-American males reported having a female IDU partner during the preceding year, while 85 percent reported having a female non-IDU partner. African-American males were more likely than white males to have sex with a non-IDU female and were more likely 16
Page 1 and 2: National Institute on Drug Abuse RE
Page 3 and 4: ACKNOWLEDGMENT This monograph is ba
Page 5 and 6: Drug Use and HIV Risk Among Male Se
Page 7 and 8: Partners. The review was held April
Page 9 and 10: Inciardi, J.A.; Lockwood, D.; and P
Page 11 and 12: highlights the critical importance
Page 13 and 14: AUTHOR Richard H. Needle, Ph.D., M.
Page 15 and 16: Blower and colleagues (1991) have p
Page 17 and 18: Even in areas with low seroprevalen
Page 19: involves using a syringe to draw bl
Page 23 and 24: victimization through theft, violen
Page 25 and 26: sharing? When are needles deliberat
Page 27 and 28: Chitwood, D.D.; McCoy, C.B.; Inciar
Page 29 and 30: Page, J.B.; Smith, P.C.; and Kane,
Page 31 and 32: HIV/AIDS Risks Among Male, Heterose
Page 33 and 34: during that time, and the possibili
Page 35 and 36: All of these issues and considerati
Page 37 and 38: ecoming the norm for both male and
Page 39 and 40: the skin on his penis while having
Page 41 and 42: REFERENCES Ball, J.C., and Chambers
Page 43 and 44: Johnson, A.M.; Petherick, A.; David
Page 45 and 46: Vogt, M.W.; Craven, D.E.; Crawford,
Page 47 and 48: transmission from males to females
Page 49 and 50: (this volume), there is little atte
Page 51 and 52: Clayton, R.; Voss, H.; Robbins, C.;
Page 53 and 54: Female Drug Abusers and the Context
Page 55 and 56: have the data but interpret it supe
Page 57 and 58: important to examine current studie
Page 59 and 60: found in this study was low socioec
Page 61 and 62: who trade sex for crack; and simila
Page 63 and 64: esponsibilities in perspective. Suc
Page 65 and 66: Robles and colleagues (1990) examin
Page 67 and 68: The lack of rational thought separa
Page 69 and 70: Factors Associated With Sexual Risk
Page 71 and 72:
Factors Associated With Poverty A n
Page 73 and 74:
encouraging such women to leave the
Page 75 and 76:
Hispanic women but extramarital aff
Page 77 and 78:
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
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Substance Use and HIV-Transmitting
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TABLE 1. Prevalence of substance us
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less than 2 percent of participants
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TABLE 2. Quantity of alcohol use am
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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
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interaction and education than men
Page 109 and 110:
Geographic differences found in the
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that they are intending or desirous
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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
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prostitutes were HIV positive, as c
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Trade hustlers are usually heterose
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TABLE 1. Number of Completed Interv
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diagnosed slightly more often than
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TABLE 2. Injection Drug Use by Type
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By the 100th interview, the screeni
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SUMMARY AND CONCLUSIONS In general,
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Plant, M. Sex work, alcohol, drugs
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HIV Risk in Drug-Using Adolescents
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AUTHOR Vincent L. Smeriglio, Ph.D.
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comprise 23 percent of all adolesce
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232 (18 percent) of the cases; and
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Although these data provide an over
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Most of these were unprotected sexu
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national epidemiologic survey of hi
Page 151 and 152:
Hawkins et al. 1992; Newcomb et al.
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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.
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Zweig Greenberg, MS.; Singh, T.; Ht
Page 161 and 162:
the types of intervention strategie
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from a study group of 52 youths who
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forearm during a sexual episode. At
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I was nice looking, like I can do a
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It is unclear whether the disinhibi
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continual sexual dysfunction was re
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TWEAKING, FREAKING, AND OVER-AMPING
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highway of love. It’s like, I’d
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Unprotected sexual activity is more
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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
Page 185 and 186:
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
Page 219 and 220:
REFERENCES Agar, M. The Professiona
Page 221 and 222:
Ouellet, L. J.; Jimenez, A.D.; John
Page 223 and 224:
Assessing the Reliability and Valid
Page 225 and 226:
TABLE 1. Sociodemographic profile o
Page 227 and 228:
Table 2 shows percentage agreement
Page 229 and 230:
FORENSIC TECHNIQUES TO DOCUMENT SEL
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cross-tabulated with dichotomous me
Page 233 and 234:
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
Page 245 and 246:
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
Page 261:
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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