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

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Gibson, D.R.; Wermuth, L.; Sorenson, J.L.; Menicucci, L.; and Bernal, G. Approval motive in self-reports of addicts and family members. Int J Addict 22:895-903, 1987. Maddux, J., and Desmond, D. Reliability and validity of information from chronic heroin users. J Psychiatr Res 12:87-95, 1975. Maisto, S.; Sobell, L.; and Sobel, M. Corroboration of drug users’ selfreports through the use of multiple sources. Am J Alcohol Drug Abuse 9:301-308, 1982. Strahan, R., and Gerbasi, K.C. Short, homogenous form of the Marlowe- Crowne social desirability scale. J Clin Psychol 28:191-193, 1972. Sudman, S., and Bradburn, N.M. Response Effects in Surveys. Chicago: Aldine, 1974. Watters, J., and Biemacki, P. Targeted sampling: Options for the study of hidden populations. Soc Probl 36:416-430, 1989. AUTHORS David R. Gibson, Ph.D. Associate Adjunct Professor Martin Young Research Associate Department of Psychiatry and Center for AIDS Prevention Studies University of California San Francisco, CA 94143 and Haight Ashbury Free Clinics San Francisco, CA 94118 235
Future Directions for Studies on the Context of HIV Risk William C. Grace, Robert J. Battjes, and Zili Sloboda The purpose of research on the context of human immunodeficiency virus (HIV) risk behaviors is to understand the myriad factors that influence and determine whether one will engage in risk behaviors. In particular, understanding contextual issues in injecting and noninjecting drug users (IDUs), sex partners of drug users, and special populations such as women, minorities, and gay or bisexual men remains an important challenge to the acquired immunodeficiency syndrome (AIDS) research community as means of preventing HIV transmission are sought and developed. The chapters in this monograph demonstrate that while important progress in understanding contextual issues has occurred, much remains to be understood. Yet, gaps in knowledge were not unanticipated, and comments from the panel reactors, Agar, Des Jarlais, and Robles were specifically solicited to identify and address understudied issues. This chapter summarizes ideas from a combination of sources. These sources include the reactors’ comments after each of the five panels in the meeting (Heterosexual Males, Women, Men Who Have Sex with Men, Adolescents, and Methodology), discussion sessions throughout the technical review meeting, and ideas developed by this chapter’s authors upon reflection on the monograph. Because the meeting did not attempt to develop agreement on issues, this chapter should not be viewed as reflecting a consensus of opinion. Themes in the discussions generally transcended specific population issues. Therefore, this chapter is not organized by populations as was the technical review itself, but presents general research issues and opportunities. MUCH REMAINS TO BE UNDERSTOOD ABOUT THE CONTEXT OF HIV RISK BEHAVIORS Participants agreed that research on the context of HIV risk behaviors remains relatively underdeveloped. Agar summed up much of the difficulty with conducting contextual research when he noted, “It is difficult to see new things when you are busy counting.” Early research 236
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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
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Jessor, R., and Jessor, S.L. Proble
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AUTHORS Mary Jane Rotheram-Borus, P
Page 189 and 190: Brunswick goes on to discuss the le
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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 and 236: aggravate self-presentation bias. T
Page 237 and 238: TABLE 8. Percent of subjects report
Page 239: intercourse, and since anal interco
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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