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

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attention paid to impoverished women, which sometimes inadvertently results in their stigmatization as part of the problem in HIV infection prevention. As experience with prevention programs for women grows during the second decade of the HIV epidemic, a new emphasis on gender-specific behavioral issues has been emerging. The conditions that underlie risk behavior, particularly those not amenable to simple informational campaigns, are most important. Increasingly, the literature points to the importance of female subordination in social, economic, and personal spheres as factors in the maintenance of women’s drug injection risk behavior, sexual risk behavior related to drug use, and sexual behavior in general. Early HIV prevention programs did not anticipate sexism as a barrier to risk reduction, but practical experience increasingly has brought it to researchers’ attention. REFERENCES Anglin, M.; Hser, Y.; and McGlothlin, W. Sex differences in addict careers: 2. Becoming addicted. Am J Drug Alcohol Abuse 13:59-71, 1987. Barnard, M. Needle sharing in context: Patterns of sharing among men and women injectors and HIV risks. Addict 88:805-812, 1993. Boyd, C. The antecedents of women’s crack cocaine abuse: Family substance abuse, sexual abuse, depression and illicit drug use. J Subst Abuse Treat 10:433-438, 1993. Brecher, E. Licit & Illicit Drugs. Boston: Little Brown & Co., 1972. Brookmeyer, R., and Gail, M. AIDS Epidemiology: A Quantitative Approach. New York: Oxford University Press, 1994. Brown, V., and Weissman, G. Women and men injecting drug users: An updated look at gender differences and risk factors. In: Brown, B., and Beschner, G., eds. At Risk for AIDS: Injection Drug Users and their Partners. Westport, CT: Greenwood Press, 1994. Brunswick, A.; Aidala, A.; Dobkin, J.; Howard, J.; Titus, S., and Banaszak-Holl, J. HIV-1 seroprevalence and risk behaviors in an urban African-American community cohort. Am J Public Health 83:1390-1394, 1993. 45
Clayton, R.; Voss, H.; Robbins, C.; and Skinner, W. Gender differences in drug use: An epidemiological perspective. In: Ray, B., and Braude, M., eds. Women & Drugs: A New Era for Research. National Institute on Drug Abuse Research Monograph No. 65. DHHS Pub. No. (ADM)90-1447. Washington, DC: Supt. of Docs., U.S. Govt. Print. Off., 1986. Cohen, J.; Alexander, P.; and Wofsey, C. Prostitutes and AIDS. AIDS Pub Policy 3:16-22, 1988. Cottler, L.; Helzer, J.; and Tipp, J. Lifetime patterns of substance use among general population subjects engaging in high risk sexual behaviors: Implications for HIV risk. Am J Drug Alcohol Abuse 16:207-222, 1990. European Study Group on Heterosexual Transmission. Comparison of male to female and female to male transmission of HIV in 563 stable couples. BMJ 304:809-813, 1992. Gordon, L. Heroes of Their Own Lives. The Politics & History of Family Violence. New York: Penguin, 1988. Grund, J.; Synn-Stem, L.; Kaplan, C.; Adriaans, N.; and Drucker, E. Drug use contexts and HIV consequences: The effect of drug policy on patterns of everyday drug use in Rotterdam and the Bronx. Br J Addiction 87:381-392, 1992. Herman, J. Trauma & Recovery. New York: Basicbooks, 1992. Hser, Y.; Anglin, M.; and Booth, M. Sex differences in addict careers: 3. Addiction. Am J Drug Alcohol Abuse 13:231-251, 1987. Ickovics, J., and Rodin, J. Women and AIDS in the United States. Epidemiology, natural history and mediating mechanisms. Health Psychol 11:1-16, 1992. Johnson, E. Women’s health: Issues in mental health, alcoholism and substance abuse. Public Health Rep 1:42-48, 1986. Kaestner, E.; Frank, B.; Marel, R.; and Schmeidler, J. Substance use among females in New York State: Catching up with the males. Adv Alcohol Subst Abuse 5:29-49, 1986. Kalickman, S.; Hunter, T.; and Kelly, J. Perceptions of AIDS susceptibility among minority and non-minority women at risk for HIV infection. J Consult Clin Psychol 60:725-732, 1992. Kane, S. HIV, heroin and heterosexual relations. Soc Sci Med 32:1037- 1050, 1991. Kozel, N., and Adams, E. Epidemiology of drug abuse. Science 234:970- 976, 1986. Longshore, D.; Hsieh, S.; and Anglin, D. Ethnic and gender differences in drug users’ perceived need for treatment. Intl J Addict 28:539-558, 1993. 46
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 and 20: involves using a syringe to draw bl
Page 21 and 22: Hispanics were less likely to repor
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: (this volume), there is little atte
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
Page 93 and 94: Substance Use and HIV-Transmitting
Page 95 and 96: TABLE 1. Prevalence of substance us
Page 97 and 98: less than 2 percent of participants
Page 99 and 100: TABLE 2. Quantity of alcohol use am
Page 101 and 102:
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
Page 107 and 108:
interaction and education than men
Page 109 and 110:
Geographic differences found in the
Page 111 and 112:
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
Page 131 and 132:
By the 100th interview, the screeni
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SUMMARY AND CONCLUSIONS In general,
Page 135 and 136:
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
Page 145 and 146:
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.
Page 153 and 154:
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
Page 165 and 166:
forearm during a sexual episode. At
Page 167 and 168:
I was nice looking, like I can do a
Page 169 and 170:
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
Page 191 and 192:
permission-giving introductions to
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conversion and perhaps even serocon
Page 195 and 196:
TABLE 1. Ecological paradigm of con
Page 197 and 198:
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
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
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aggravate self-presentation bias. T
Page 237 and 238:
TABLE 8. Percent of subjects report
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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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