Reflections on 25 Years of HIV and AIDS Research among Drug Abusers

• Author: Samuel R. Friedman,Don C. Des Jarlais,Robert E. Booth
• Published date: 01 January 2009
• DOI: 10.1177/002204260903900116
• Date: 01 January 2009
• Subject Matter: Article

© 2009 BY THE JOURNAL OF DRUG ISSUES

JOURNAL OF DRUG ISSUES 0022-0426/09/01 209-222

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Robert E. Booth, Ph.D., is a Professor of Psychiatry at the University of Colorado Health Sciences

Center. For more than 20 years, he has focused on developing and evaluating interventions de-

signed to prevent the spread of HIV among drug injectors. This work is currently being conducted in

Denver and at several sites in Ukraine. Don C. Des Jarlais, Ph.D., is the Director of Research at the

Baron Edmond de Rothschild Chemical Dependency Institute of Beth Israel Medical Center, a Senior

Research Fellow at the National Development and Research Institutes, and Professor of Epidemiol-

ogy and Social Medicine at Albert Einstein College of Medicine, New York, New York. He specializes

in research on addiction and HIV/AIDS among injecting drug users. Samuel R. Friedman, Ph.D.,

is Theoretical Synthesis Core Director in the Center for Drug Use and HIV Research at NDRI. His

research includes how some long-term drug injectors remain HIV- and HCV-negative, socioeconomic

and policy factors that predict metropolitan area prevalence of injection drug use, and HIV and HCV

prevention efforts.

REFLECTIONS ON 25 YEARS OF HIV AND AIDS

RESEARCH AMONG DRUG ABUSERS

ROBERT E. BOOTH, DON C. DES JARLAIS, SAMUEL R. FRIEDMAN

Booth: Since early in the HIV epidemic, street outreach workers, often indigenous to

the target population, have served both to recruit drug injectors for interventions and

to conduct interventions. The typically unstructured nature of outreach interventions

present challenges in determining the nature of services actually delivered. It is

recommended that both qualitative and quantitative methods be utilized to monitor

intervention service delivery. Des Jarlais: The threat of AIDS has led to profound

behavioral changes among drug users. These changes need to be seen primarily

not as responses to public health interventions, but in terms of the competencies of

drug users themselves. A Drug User Competency Model of HIV Prevention would

include: 1. Competency in understanding HIV transmission, 2. Competency in

reducing HIV risk behavior, and 3. The competency of altruism. Friedman: Twenty

years of work on HIV among drug users highlight that we need to incorporate large-

scale social dynamics in research and interventions, understand drug users’ sexual

behavior and networks, and view drug users as multifaceted human beings, not

just “walking addictions.” Crucially, drug users can be highly competent at many

things, so non-users can learn from their ideas and their practices. Drug users can

be partners and sometimes leaders, not just “disabled addicts.”