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

contextual issues despite an apparent availability of some relevant data
are not unique. The author wishes to emphasize that results specific to
female subjects are needed and important.
CONCLUSION
This sample of research literature on high-risk behaviors of female drug
abusers shows much diversity in attention to contextual issues. There
often is a lack of asking research questions, collecting data, and reporting
findings from a perspective that includes enough information to form a
picture of the contextual situation in which these women exist, use drugs,
and succumb to HIV through high-risk behavior. Studies should attempt
to not only present associations, but also to explain why there is
continued high-risk behavior despite the danger. Information on the
emotional, psychological, familial, and social-environmental contexts of
high-risk behaviors among female drug users is sorely needed.
Explanatory systems, such as level of differentiation of self, could help
make sense of such statements as “I would like to get treatment for my
drug use, but I know that being drug free is like a pie in the sky dream for
me.” Bowen’s system also can be used to explain a number of current
observations on both individual and community levels.
From a community perspective, because Bowen’s theory posits that level
of self-differentiation is passed down among generations and that
children will be similar to parents in level of self-differentiation, one
would not expect problems to be limited to individuals within a family.
In fact, AIDS is affecting entire families and generations in African-
American neighborhoods. An example is a 51-year-old IVDU woman
who is HIV positive; her 36-year-old son just recently died of AIDS; and
her sister recently died of AIDS. Another example of this phenomenon is
a woman who injects heroin and is HIV positive; her daughter is cocaine
addicted and is HIV positive from high-risk sexual behavior; and her
daughter’s child is HIV positive. All of this in one family! Families in
some African-American communities are accepting the disease and
resulting death as a routine part of life, and children are growing up in
environments where the norm is for many adults to have AIDS. The
children are learning dysfunctional patterns (using drugs to deal with
issues, make life comfortable, and relieve the anxiety of relationships and
participation in high-risk behaviors) that may be passed on to other
generations.
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