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

degrading sexual acts, poignantly made the connection between this
behavior and his position within the larger society:
Power. I think it’s this feeling that you can dominate somebody.
You know, cause here you know they beg for it. It just turns some
guys on. Like, gimme that and I’ll do this for you. Most guys if
they’ve got cocaine they think they have power cause cocaine bring
them money. It make you think you have power. I don’t know, that
you can dominate. Yeah I don’t know, I like power. I’m just dying
sort of like. But then every once in awhile I like to feel like I’m
important and all that, like I got something you know (Koester and
Schwartz 1993, p. 197).
Ethnographers also have studied the role the criminal justice system and
law enforcement play in the lives of drug users. Mason described the
drug subculture she studied in Baltimore as “being constituted and
reconstituted in opposition to law enforcement and criminal justice
representatives...” (1989, p. 8). Several studies have demonstrated how
drug users’ responses to legal constraints on syringe access and the
strategies they use to avoid interactions with the police may lead to highrisk
injection episodes (Clatts et al. in press; Carlson et al. in press;
Feldman and Biernacki 1988; Fernando 1991; Koester 1989, 1994;
Mason 1989; Oulette et al. 1991; Page et al. 1990; Singer 1991; Watters
1989).
In Chicago, ethnographers led by Oulette demonstrated how differences
in the frequency of needle sharing among clients of shooting galleries
were due, in part, to the socioeconomic status and political power of the
neighborhood where they were located. These researchers found a
relationship between a community’s economic and political power and
the level of police attention it received. In poor neighborhoods, police
largely ignored shooting gallery operations. As a result, galleries
operated as businesses, with relatively little danger of being raided. They
were well-managed with strict house rules, including rules governing
needle hygiene. They also were accessible to HIV intervention efforts.
In contrast, syringe sharing was common in the more hidden, low-volume
galleries that typified neighborhoods undergoing gentrification. Greater
police presence in these neighborhoods discouraged larger, more
established galleries. Instead, private “taste” galleries were the norm.
These were users’ apartments, where a small group of injectors could
exchange a portion of their drugs for a place to inject. These small,
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