Search

This paper focuses on past, present, and potential future contributions of ethnographic research to describing and understanding istreet culturesi of drug use and the implications these have for informing various interventions. The first section provides an overview of ethnography and drug abuse research. This is followed by a historical perspective on the ethnography of street cultures. Next, the significance of ethnographic drug abuse research is highlighted, with a focus on its methodology. Ethnographic contributions to the development, implementation, and evaluation of interventions are discussed, including ethical issues. Subsequently, the interdisciplinary nature of ethnographic drug abuse research is described. Methodological challenges emerged over time as the definition of street cultures and drug trends shifted. These are illustrated with examples, including the use of prescription drugs, new heroin users, and rural drug and methamphetamine use. The final sections focus on career opportunities for ethnographers and opportunities and barriers for the future. We address training needs for interdisciplinary inquiry, the potential role of ethnographers in prevention and treatment research, and the link to studies on the brain and genetics. The future of ethnographic research on drug use will be influenced by the funding structure. We conclude with a summary of reflections on the past and aspirations for the future.

There has been considerable discussion in the research ethics literature concerning special researcher responsibilities in studying vulnerable populations, including whether or not drug addicts, as a result of their health condition and craving for drugs, constitute a vulnerable group from a human subject perspective. In the assessment of ethical issues, researchers in recent years have begun to recognize the critical importance of hearing the subject's voice and learning the concerns and attitudes of those who participate in research. To date, however, despite a significant increase in studies of not-in-treatment drug users, little attempt has been made to determine the perspectives of drug users about participation in research, especially ethnic minority drug users, and in particular, Hispanic drug users. Based on recent findings of a study of drug user attitudes and perspectives on research, this paper reports on the perceived risks and benefits of participation in research of a subsample of Hispanic street drug users from Hartford, Connecticut

Injection drug users are at high risk for hepatitis B virus infections. Nevertheless, few concerted efforts have been made to provide injectors with access to an available, safe, and effective vaccine. A campaign to screen and vaccinate injectors was conducted at syringe exchange programs in Chicago, Illinois, and Hartford and Bridgeport, Connecticut. Injectors with no evidence of past hepatitis B infection were eligible for vaccination. Eligible injectors were offered the three doses of vaccine and questioned about their past and current drug use, their sociodemographics, their understanding of hepatitis infections, and their motivation for participating in the study. Disease prevalence, vaccination rates, and the answers to study questions were analyzed comparing the sample of Hispanic to non-Hispanic injectors. We screened 1970 injectors, 660 of whom were eligible for vaccination. Of those, 591 received at least one dose of the vaccine. Hispanics comprised 30.9% of those screened, 24.9% of those eligible, and 25.2% of those receiving at least one dose. Hispanics were more likely than non-Hispanic Whites or non-Hispanic Blacks to have already been infected with hepatitis B--55.6% for Hispanics versus 46.5% for non-Hispanics. Although it is impossible to generalize from our study population to Hispanic injectors as a whole, it seems apparent that if greater efforts are made to promote hepatitis B vaccination among Hispanics, high rates of vaccination can be achieved.

Many researchers believed that drug users would be resistant to AIDS prevention behavioral change. However, studies conducted through the National Institute on Drug Abuse's Cooperative Agreement for AIDS Community-Based Outreach/Intervention Research have shown that AIDS prevention programs targeted at drug users are effective in stimulating significant behavioral changes. The results of such studies have laid the foundation for more in-depth AIDS prevention model construction.

A study of drug use locations in Hartford, CT, is designed to understand the environmental and social conditions within 'high risk sites' where drug users inject drugs or smoke crack, in order to develop AIDS prevention models that build upon the physical and social organization of these locations. The study assesses high-risk sites characterized on the basis of type of location or structure, presence and strength of gatekeepers, and presence and strength of HIV prevention opportunities and pressures. A combination of ethnographic, epidemiological, and social network methods are used to document the characteristics, social organization, natural history, and dynamics of these sites, the network relations of site users, and the various opportunities for, or barriers to, on-site social-level HIV prevention intervention. This paper provides an overview of the study and presents preliminary findings, including the degree to which drug injectors and crack smokers use specific types of sites in Hartford. The paper also discusses the ways these findings inform development of on-site, type-specific and peer-led or structural HIV-prevention interventions.