HIV Prevention Sex and the Methodology Chapter

The depth of the problem can be seen in the results of a survey reported by Booth, Koester, Brewster, and Weibel (1991) which show that over fifty percent of the subjects injected drugs on a daily basis, while 70% shared needles with other addicts. Only 22% used a disinfectant with their needles every time they injected. It was further found that 86% shared a "cooker" with other users, and nearly fifty percent reported injecting in a shooting gallery. These subjects were not merely dangerous to themselves, either, since 90% reported having sexual relations in the six months prior to the interview, with one-half having had multiple partners. The subjects rarely used condoms (Booth, Koester, Brewster, and Weibel, 1991).

This was the situation after a long effort at public education on the dangers of HIV infection and ways to avoid it. Leukefeld, Battjes, and Amsel (1990) suggest, along with many other professionals and researchers, that prevention efforts to reduce the risk of AIDS among IV drug users should be a priority considering the high levels of AIDS risk behavior within this population and the fact that the sexual partners of IV drug users are also at risk (Leukefeld, Battjes, and Amsel, 1990). The sharing of needles is the primary risk factor for IV drug users. Lishner and Look (1990) emphasize that this is one of the major means of transmission of the HIV virus into the general population. Education and other programs have thus addressed the matter with the hope of reducing the incidence of high risk behavior, with mixed results. Lishner and Look cite the case of Seattle where liberal laws made acquisition of needles relatively easy, the assumption being that needle sharing would then not be a significant problem.However, a follow up survey shows that it remains a significant problem that addicts still share needles and that they still fail to sterilize their needles between uses (Lishner & Look, 1990). The spread of HIV to a younger and younger population has also been part of the ongoing spread of the disease, creating new fears about the social devastation the disease would bring. Fears of what HIV means to society as a whole have been present for some time, and analysts have stated that the capacity of the voluntary sector to respond to continuing and new needs will be sorely tested (Jonsen & Stryker, 1993). Higher rates among adolescents will make this even more difficult. The basic methods for prevention were set early. Chitwood, McCoy, and Comerford (1990) examined a number of treatment and prevention modalities and set forth several characteristics they saw as most effective for such programs.

They stated that the most effective intervention strategy would include ethnic? And gender specific interventions; acknowledge the compulsive nature of cocaine; convince IV drug users to sterilize needles and syringes; focus on high-risk sexual behavior; and follow up reinforcement of behavioral changes achieved at initial intervention (Chitwood, McCoy, and Comerford, 1990). Many of these assumptions, while adopted, have not been fully tested for efficacy. Education for the young has become more and more a part of efforts to reduce the incidence of HIV. Education is seen as critical because AIDS is not curable. Many young.....