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Theorists posit that personal decisions to disclose being HIV positive are made based on the perceived consequences of that disclosure. This study examines the perceived costs and benefits of self-disclosure among African American injection drug users (IDUs).A total of 80 African American IDUs were interviewed in-depth subsequent to testing HIV positive. Participants reported that interpersonal costs of self-disclosure included stigma, loss of sexual/romantic partners, emotional harming of family/friends, shattering of privacy, physical isolation, blame, and loss of income. The benefits of disclosure included social support, emotional catharsis, and income. Four factors that help to tip the scales in either direction were identified. Study findings have implications for the delivery of counseling, testing, and partner notification services to African American IDUs living with HIV. [ABSTRACT FROM AUTHOR]

Recognizing that HIV transmission occurs within situated interactions between two or more people, prevention research has increasingly begun to focus on identifying the influence of situations and settings on the spread of HIV. Examination of the social geography of risk has emerged as a powerful tool for understanding where and among whom risky practices occur. In this regard, shooting galleries represent interactional territories where the normative expectations of participation within their spatial boundaries can both encourage and reinforce sex- and drug-related risky behavior. Indeed, research shows that those who inject in shooting galleries tend to be at a higher risk of transmitting HIV than those who inject elsewhere. Drawing upon data from a sample of 1,113 active injecting drug users, we examined the demographic and psychosocial factors that predict shooting gallery use. Next, we compared shooting gallery users with nonusers in terms of drug use, followed by an examination of differences in sex- and drug-related HIV risk behaviors. Then, we explored preventive practices that possibly differentiate those who use shooting galleries from those who do not. We end our analysis by discussing the implications of our results for HIV prevention and social policy. [ABSTRACT FROM AUTHOR]

Explores what is known about HIV and older substance abusers with emphasis on the age-related factors that shape the experience od AIDS for this population. Risk for HIV among older injectors; Biological vulnerability for HIV; Cohort and historical effects; Snapshot view of the older injector's risk for AIDS.

This article examines the outreach-assisted peer-support (OAPS) model of group interaction as an innovative strategy to help active street addicts control, reduce, or stop their use of drugs. The OAPS model targets active street addicts who are not in treatment and who may elect to continue drug use while participating in an OAPS group. Community-outreach and network sampling methods were used to recruit active heroin and cocaine users. One hundred street addicts were invited to participate voluntarily in outreach staff-assisted, peer-support groups sessions held at two community-based sites in Chicago. Data are drawn from regular indepth interviews, ethnographic reports, and transcribed tapes of OAPS sessions. The analysis focuses on the social processes through which peers help peers to stop, control, or reduce the harm of using illegal drugs. [ABSTRACT FROM AUTHOR]

Examines how the institutional, the informal and the underground economy converge within the representative payee system, a federal program designed to provide needed income to poor, inner-city residents in the United States. Overview of the representative payee system; Description of the process of becoming a payee or a client; Relationship between payees and clients.

This paper examines self-perceptions of risk for AIDS and factors that contribute to estimations of risk. On the basis of a telephone survey of 1,540 adults age 18 to 60, we address the question: What heuristic factors predict perception of risk for AIDS? Results show that five heuristic categories determine self-perceptions of risk: sexual practices, moral evaluations of people with AIDS, emotional response to AIDS, protective actions in response to AIDS, and demographic characteristics. Number of sexual partners over the past five years and knowledge of sexual partners' past sexual behavior are associated significantly with increased perceptions of risk. Fear of AIDS and worry about one's health also contribute significantly to self-perception of risk, as does shame associated with having AIDS. Asian-Americans and persons with no particular religious affiliation report greater perceptions of risk. These findings call attention to heuristic factors in considering theories of risk and in designing interventions to change preventive actions associated with high risk for AIDS. [ABSTRACT FROM AUTHOR]

Partner services provide a safe and humane way for people living with HIV (PLWH) to alert their sex and/or drug-injecting partners to the possibility of HIV exposure and the need for HIV testing, yet little is known about the ethical challenges of delivering partner services in prisons. In this article, we consider 7 key ethical and methodological questions that should be considered when developing, testing, or implementing partner services in prison settings. These questions relate to the ethics of: (1) mandatory HIV testing, (2) health illiteracy, (3) level of prison staff involvement, (4) protecting confidentiality, (5) minimizing harm, (6) achieving equivalency with community standards of care, and (7) providing HIV prevention and treatment services to index patient and their partners. By assisting PLWH in prison to inform partners with whom they may have shared HIV exposure either before or during incarceration, partner services can help to identify cases of undiagnosed HIV infection for testing and linkage to medical care. The acceptability and effectiveness of a future partner services model for PLWH in prison depends critically on answering these 7 questions to assure the highest ethical standards of research and practice. [ABSTRACT FROM AUTHOR]