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

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having bleach available.” Similar statements preceded questions about condom use and anal intercourse. The hypothesis concerning questions asked late versus early in the interview was predicated on the belief that rapport develops between an interviewer and a respondent in the course of an interview, increasing the comfort level of the respondent and thereby making it more likely that the respondent will reveal unfavorable information. While the literature on order effects reveals a mixed pattern of findings (Sudman and Bradbum 1974; Bradbum and Sudman 1979), the authors’ experience working with IVDUs suggested this would be the case. Table 8 shows the results of the experiment with interview formats. The long questions elicited significantly higher levels of reported borrowing of syringes and a higher reporting level of lifetime practice of anal intercourse. They appeared to have little impact, however, on selfreported condom use. Order (early versus late) effects were observed for only one variable, condom use for the previous 30 days; respondents asked this question late in the interview were more likely to disclose condom use. This finding is difficult to interpret, but it may have been related to an association of condoms with loose sexual morals, making it less likely that respondents would admit to using them early in the interview. There were no significant interactions between the long versus short and early versus late manipulations. Matching Gender of Interviewers and Respondents In a separate experiment, the authors randomized male and female respondents to male and female interviewers to determine whether responses to questions about sexual behavior might be influenced by the gender of interviewer, respondent, or both. Although Sudman and Bradbum’s (1974) review of the literature suggested the characteristics of interviewers and respondents have little effect on responses to questions about behavior, an apparent exception is situations in which interviewer/respondent characteristics are related to the subject matter. Table 9 shows the results of the randomized experiment. There were no statistically significant main effects of interviewer gender. In two trends, women respondents were less likely to acknowledge to a female interviewer that they had vaginal intercourse but more likely to report using condoms consistently. Other patterns were evident but not 231
TABLE 8. Percent of subjects reporting behaviors in response to long versus short questions and to questions asked early versus late in the interview (N = 508) Long versus short questions Borrowed dirty syringe, past 6 months Borrowed dirty syringe, past 30 days Used condoms, ever Used condoms some, past 30 days Used condoms 100 percent, past 30 days Anal intercourse, ever Anal intercourse, past 6 months Early versus late questions Percent of subjects reporting behavior Long Short question question 47.8 46.9 43.3* 32.8* 86.6 85.6 38.4 36.5 21.5 16.9 66.4* 57.8* 13.6 14.0 Percent of subjects reporting behavior Early Late question question Borrowed dirty syringe, past 6 months 48.2 46.5 Borrowed dirty syringe, past 30 days 39.0 37.0 Used condoms, ever 84.3 87.8 Used condoms some, past 30 days 31.5* 43.1* Used condoms 100 percent, past 30 days 16.9 21.3 Anal intercourse, ever 60.2 63.8 Anal intercourse, past 6 months 11.2 16.3 *Differences significant at p < 0.05. statistically significant. Female respondents were less likely to report condom use to male interviewers, perhaps reflecting an association of condoms with easy virtue; male respondents were more likely to report vaginal, oral, and anal sex to male interviewers, suggesting what a colleague has called a braggadocio effect, men exaggerating their sexual prowess to other males. It is possible that research with larger samples might find these relationships to be statistically significant. 232
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National Institute on Drug Abuse RE
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ACKNOWLEDGMENT This monograph is ba
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Drug Use and HIV Risk Among Male Se
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Partners. The review was held April
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Inciardi, J.A.; Lockwood, D.; and P
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highlights the critical importance
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AUTHOR Richard H. Needle, Ph.D., M.
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Blower and colleagues (1991) have p
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Even in areas with low seroprevalen
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involves using a syringe to draw bl
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Hispanics were less likely to repor
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victimization through theft, violen
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sharing? When are needles deliberat
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Chitwood, D.D.; McCoy, C.B.; Inciar
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Page, J.B.; Smith, P.C.; and Kane,
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HIV/AIDS Risks Among Male, Heterose
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during that time, and the possibili
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All of these issues and considerati
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ecoming the norm for both male and
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the skin on his penis while having
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REFERENCES Ball, J.C., and Chambers
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Johnson, A.M.; Petherick, A.; David
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Vogt, M.W.; Craven, D.E.; Crawford,
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transmission from males to females
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(this volume), there is little atte
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Clayton, R.; Voss, H.; Robbins, C.;
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Female Drug Abusers and the Context
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have the data but interpret it supe
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important to examine current studie
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found in this study was low socioec
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who trade sex for crack; and simila
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esponsibilities in perspective. Suc
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Robles and colleagues (1990) examin
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The lack of rational thought separa
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Factors Associated With Sexual Risk
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Factors Associated With Poverty A n
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encouraging such women to leave the
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Hispanic women but extramarital aff
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coherence—the sense that life is
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the change agent may be a crucial f
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Centers for Disease Control and Pre
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Jemmott, J.B.; Jemmott, L.S.; Spear
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O’Leary, A.; Celentano, D.; Maiba
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Drug Use and HIV Risk Among Gay and
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with 34.6 percent of gay men and 28
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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,
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in mind, however, that most of the
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seropositivity and reported NMPD us
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interaction and education than men
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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
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REFERENCES Calzavara, L.M.; Coates,
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Ostrow, D.G.; Beltran, E.; Chmiel,
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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
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Hawkins et al. 1992; Newcomb et al.
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higher rates of HIV/AIDS in adolesc
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Boyer, C.B. Psychosocial, behaviora
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Irwin, C.E., Jr., and Shafer, M.A.
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Zweig Greenberg, MS.; Singh, T.; Ht
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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
Page 187 and 188: AUTHORS Mary Jane Rotheram-Borus, P
Page 189 and 190: Brunswick goes on to discuss the le
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Page 193 and 194: conversion and perhaps even serocon
Page 195 and 196: TABLE 1. Ecological paradigm of con
Page 197 and 198: TECHNICAL ISSUES Technical issues i
Page 199 and 200: eliability. It seems obvious that q
Page 201 and 202: sometimes as many as three zip code
Page 203 and 204: Resources and effort are required t
Page 205 and 206: Brunswick, A.F.; Lewis, C.S.; and M
Page 207 and 208: The Context of Risk: Ethnographic C
Page 209 and 210: same meaning may be extended to dru
Page 211 and 212: THE CONTEXT OF RISK Context is an a
Page 213 and 214: hurried, and adequate needle cleani
Page 215 and 216: degrading sexual acts, poignantly m
Page 217 and 218: 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
Page 231 and 232: cross-tabulated with dichotomous me
Page 233 and 234: TABLE 6. Relationship of question t
Page 235: aggravate self-presentation bias. T
Page 239 and 240: intercourse, and since anal interco
Page 241 and 242: Future Directions for Studies on th
Page 243 and 244: abusers, and other variables are ne
Page 245 and 246: Behavior patterns can be clarified
Page 247 and 248: As Des Jarlais noted, designs and a
Page 249 and 250: strengths within a setting or indiv
Page 251 and 252: National Institute on While limited
Page 253 and 254: 62 NEUROSCIENCE METHODS IN DRUG ABU
Page 255 and 256: 89 BIOLOGICAL VULNERABILITY TO DRUG
Page 257 and 258: 111 MOLECULAR APPROACHES TO DRUG AB
Page 259 and 260: 127 PROGRESS AND ISSUES IN CASE MAN
Page 261: NIH Publication No. 94-3750 Printed
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