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

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Darke, S.; Hall, W.; Ross, M.; and Wodak, A. Benzodiazepine use and HIV risk taking behavior among injecting drug users. Drug Alcohol Depend 31:31-36, 1992. Des Jarlais, D.; Abdul-Quader, A.; Minkoff, H.; and Tross, S. Crack use and multiple AIDS risk behaviors. J Acquir Immune Defic Syndr 4(4):446-447, 1991. Forney, M.; Inciardi, J.; and Lockwood, D. Exchanging sex for crackcocaine: A comparison of women from rural and urban communities. J Community Health 17(2):73-85, 1992. Frischer, M.; Haw, S.; Bloor, M.; Goldberg, D.; Green, S.; McKeganey, N.; and Covell, R. Modeling the behavior and attributes of injecting drug users: A new approach to identifying HIV risk practices. Int J Addict 28(2):129-152, 1993. Ickovics, J., and Rodin, J. Women and AIDS in the United States: Epidemiology, natural history, and mediating mechanisms. Health Psychol 11(1):1-16, 1992. Kang, S., and De Leon, G. Correlates of drug injection behaviors among methadone outpatients. Am J Drug Alcohol Abuse 19(1):107-118, 1993. Kline, A.; Kline, E.; and Oken, E. Minority women and sexual choice in the age of AIDS. Soc Sci Med 34(4):447-457, 1992. Lewis, D., and Watters, J. Sexual risk behavior among heterosexual intravenous drug users: Ethnic and gender variations. AIDS 5:77-83, 1991. Papero, D. Bowen Family Systems Theory. Boston: Allyn and Bacon, 1990. Robles, R.; Colon, H.; Gonzalez, A.; and Mateos, R. Social relations and empowerment of sexual partners of IV drug users. P R Health Sci J 9(1):99-104, 1990. AUTHOR Karen Allen, Ph.D., R.N., CARN University of Maryland School of Nursing Department of Psychiatric, Community Health, and Adult Primary Care Community Addictions Nursing Program 734 Parsons Hall 622 West Lombard Street Baltimore, MD 21201-1579 63
Factors Associated With Sexual Risk of AIDS in Women Ann O’Leary INTRODUCTION Women are increasingly represented among U.S. acquired immunodeficiency syndrome (AIDS) cases. As of December 1992, almost 28,000 cases of AIDS in women had been reported to the Centers for Disease Control and Prevention (CDC) (Centers for Disease Control and Prevention 1993b). However, nearly half of these (44 percent) were reported during 1991 and 1992 alone, reflecting a dramatic increase in the rate of female infection (Centers for Disease Control and Prevention 1993a). The number of cases of AIDS in women has been projected to become between 55,000 and 75,000 by the end of 1994 (Centers for Disease Control and Prevention, 1992). As the number of women with human immunodeficiency virus (HIV) infection and AIDS has grown, numerous considerations specific to women have arisen. These concern differences in disease course and treatment, issues in the prevention of infection, and effects of stigmatization (Ickovics and Rodin 1992; O’Leary et al. 1993b). This chapter describes the extant research concerning the structural and personal factors related to sexual risk for HIV infection in women, with special reference to female partners of drug users. Following is a brief description of prevention programs that have been evaluated, a discussion of female-centered prevention strategies, and recommendations for future research and intervention. WOMEN AND AIDS: WHO IS AT RISK? Within the United States, women are a rapidly growing segment of the population infected with HIV, the cause of AIDS. Their representation among persons with AIDS, expressed as a percentage of the total AIDS cases reported, increased from about 3 percent in 1981, when the first cases were reported to the CDC, to 12 percent in 1990 (Ellerbrock et al. 1991). AIDS is now the leading cause of death among African-American women of reproductive age (ages 15 to 44) in New York and New Jersey (Chu et al. 1990). Heterosexual transmission, which appears to be more efficient when the infected partner is male (Padian et al. 1991), also has 64
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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
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 and 50: (this volume), there is little atte
Page 51 and 52: Clayton, R.; Voss, H.; Robbins, C.;
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: The lack of rational thought separa
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
Page 113 and 114: 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
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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
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Brunswick goes on to discuss the le
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permission-giving introductions to
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conversion and perhaps even serocon
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TABLE 1. Ecological paradigm of con
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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
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Resources and effort are required t
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Brunswick, A.F.; Lewis, C.S.; and M
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The Context of Risk: Ethnographic C
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same meaning may be extended to dru
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THE CONTEXT OF RISK Context is an a
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hurried, and adequate needle cleani
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degrading sexual acts, poignantly m
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searched me and I had stashed the c
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REFERENCES Agar, M. The Professiona
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Ouellet, L. J.; Jimenez, A.D.; John
Page 223 and 224:
Assessing the Reliability and Valid
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TABLE 1. Sociodemographic profile o
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Table 2 shows percentage agreement
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FORENSIC TECHNIQUES TO DOCUMENT SEL
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cross-tabulated with dichotomous me
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TABLE 6. Relationship of question t
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aggravate self-presentation bias. T
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TABLE 8. Percent of subjects report
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intercourse, and since anal interco
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Future Directions for Studies on th
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abusers, and other variables are ne
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Behavior patterns can be clarified
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As Des Jarlais noted, designs and a
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strengths within a setting or indiv
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National Institute on While limited
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62 NEUROSCIENCE METHODS IN DRUG ABU
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89 BIOLOGICAL VULNERABILITY TO DRUG
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111 MOLECULAR APPROACHES TO DRUG AB
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127 PROGRESS AND ISSUES IN CASE MAN
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NIH Publication No. 94-3750 Printed
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