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

important to examine current studies to see if this or similar theoretical
bases are being used or could be used to guide and interpret extant
research.
REVIEW OF CURRENT RESEARCH
One example is the research currently being conducted at the University
of Maryland School of Nursing. This study is aimed at reducing the
high-risk behaviors of needle sharing and sex without condoms among
African-American female IDUs. It is a 3-year experimental design study
targeted for 200 subjects in a methadone maintenance program. The
study is called the Peer Counseling and Leadership Training (PCLT)
program, and it focuses on control and self-esteem as critical issues in
development of efficacious selves, sex and sexuality as related to AIDS,
and self-reported lifestyles that have implications for drug use and sexual
behaviors. The goal of this intervention is empowerment through
instillation of a sense of inner control and motivation based on increased
self-esteem and competency involving self, relationships with others, and
involvement with the community. Particular attention is paid to
sensitivity to and management of relationships with others and to
attitudes involving trust, competence, confidence, positive thinking,
personal direction, and self-identity (R.M. Harris, personal
communication, March 18, 1993).
This research does appear to be addressing some of the contextual issues
of HIV transmission among female drug abusers. The activities in the
intervention are consistent with the Bowen Family Systems Theory and
could be seen as helping women develop a solid self as well as appealing
to their intellect for increasing their ability to determine their behavior
based on thinking rather than emotional reactivity. It could be argued
that the effect of the intervention is to change a major factor in behavior,
low level of differentiation of self. However, because the researchers are
not viewing the subjects’ self as having developed as a result of
embodying emotional processes and patterns of previous generations, the
expectation is that intended changes resulting from the intervention will
happen soon. Bowen (1978) states that an increase in the level of
differentiation of self is gradual and takes a while to accomplish.
According to Harris, one initial finding from this study is that the partners
of female drug users lend the women’s equipment to other IDUs. Hence,
some female drug users are not necessarily sharing their needles and
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