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

unemployment for Harlem youth is at least twice the citywide rate of
8.1 percent, and the economic incentive to participate in the burgeoning
crack economy is overwhelming” (1989b, p. 63). He describes how those
pursuing careers in the crack economy are no longer exploitable by the
“white man.” They speak with anger of their former legal jobs and the
exploitation they endured, and “... make fun of friends and
acquaintances—many of whom come to buy drugs from them-who are
still employed in factories or in service jobs... All of them have, at one
time or another, held the jobs-delivery boys, supermarket baggers,
hospital orderlies—that are objectively recognized as among the least
desirable jobs in American society. They see the illegal, underground
economy as not only offering superior wages, but also a more dignified
work place” (1989b, p.63).
Similarly, Clatts and colleagues (in press), in their ethnographic studies of
New York’s Lower Eastside, describe how poverty and loss of lowincome
housing units to conversion, urban renewal, and reductions in
federally subsidized housing contribute to homelessness and how
homelessness leads to poor health. For drug injectors, homelessness
undermines the degree of risk reduction that can be accomplished and
sustained. These injectors are without reliable places to use drugs or keep
drug-using paraphernalia.
In an ethnographic study of crack-using women in New York City,
Maher and Curtis (1992) contend that “...the position of women crack
smokers can only be understood by locating their lives, their illicit drug
use and their income generating activities within the context of a specific
set of localized socio-economic and cultural developments” (p. 221).
Specifically, they contend that these women’s crack use, criminality, and
experiences with violence only can be understood within the context of
gender relations and their opportunities in both the formal and informal
economies. Similar findings were noted by several of the ethnographers
in the NIDA-funded eight-city ethnographic study examining the
phenomenon of sex-for-crack exchanges (Ratner 1993). Several of these
studies linked the powerlessness that characterized these women’s lives,
as well as the lives of their addicted male counterparts, to comparable
socioeconomic and cultural factors. A male crack user in Denver,
commenting on why he often asked crack-addicted women to engage in
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