THE RELEVANCE OF DRUG INJECTORS SOCIAL AND RISK NETWORKS FOR UNDERSTANDING AND PREVENTING HIV-INFECTION
THE RELEVANCE OF DRUG INJECTORS SOCIAL AND RISK NETWORKS FOR UNDERSTANDING AND PREVENTING HIV-INFECTION
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DOI：
10.1016/0277-9536(94)90301-8
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发表时间：
1994-01-01
影响因子：
5.4
通讯作者：
WRIGHT, JW
中科院分区：
文献类型：
--
作者：
NEAIGUS, A;FRIEDMAN, SR;WRIGHT, JW
关注社会环境和个人既能增进我们对艾滋病毒传播的了解，又能帮助制定更有效的预防方案。网络是毒品注射者社会环境的一个重要方面。我们区分了(1)作为疾病传播媒介的风险网络（发生艾滋病毒风险行为的人）和(2)作为社会影响的产生者和传播者的社会网络（其中存在相互倾向的社会互动的人）。在两项研究中，这些概念被应用于对药物注射者访谈数据的分析。在第一项研究中，毒品注射者的风险网络与他们的社会网络趋同：70%的人与配偶或性伴侣、跑步伙伴、朋友或他们认识的其他人一起注射或共用注射器。第二项研究中对注射者的访谈所得的定性数据还表明，注射者与其风险网络成员之间的社会关系往往基于长期和多重关系，例如基于亲属关系、友谊、婚姻和性关系以及经济活动的关系。在第一项研究中，绝大多数注射者（超过90%）与非注射者有社会关系。与非注射者有更频繁社会接触的注射者从事的注射危险行为水平较低。风险环境可能起到风险网络的作用：在本研究中，在射击场注射的注射者比不在射击场注射的注射者更有可能租用二手注射器，借用二手注射器并与陌生人一起注射。由于采用网络方法相对较新，因此需要进一步注意若干问题。其中包括：如何利用毒品注射者之间的社会网络，通过同侪压力降低风险；如何通过鼓励注射者和非注射者之间的联系来促进减少风险；以及如何将传记性和历史性的变化结合起来理解网络过程。应该开发研究药物注射者网络的适当方法，包括接触隐藏人群的技术，管理和分析网络数据库的计算机软件，以及从通过相关抽样设计收集的数据中得出推论的统计方法。
Focusing on the social environment as well as the individual should both enhance our understanding of HIV transmission and assist in the development of more effective prevention programs. Networks are an important aspect of drug injectors' social environment. We distinguish between (1) risk networks (the people among whom HIV risk behaviors occur) as vectors of disease transmission, and (2) social networks (the people among whom there are social interactions with a mutual orientation to one another) as generators and disseminators of social influence. These concepts are applied to analyses of data from interviews with drug injectors in two studies. In the first study drug injectors' risk networks converge with their social networks: 70% inject or share syringes with a spouse or sex partner, a running partner, or with friends or others whom they know. Qualitative data from interviews with injectors in the second study also show that the social relationships between drug injectors and members of their risk network are often based on long-standing and multiplex relationships, such as those based on kinship, friendship, marital and sexual ties, and economic activity. In the first study the vast majority of injectors, over 90%, have social ties with non-injectors. Injectors with more frequent social contacts with non-injectors engage in lower levels of injecting risk behavior. Risk settings may function as risk networks: injectors in this study who inject at shooting galleries are more likely than those who do not to rent used syringes, borrow used syringes and inject with strangers. Since the adoption of a network approach is relatively new, a number of issues require further attention. These include: how to utilize social networks among drug injectors to reduce risk through peer pressure; how to promote risk reduction by encouraging ties between injectors and non-injectors; and how to integrate biographical and historical change into understanding network processes. Appropriate methodologies to study drug injectors' networks should be developed, including techniques to reach hidden populations, computer software for managing and analyzing network data bases, and statistical methods for drawing inferences from data gathered through dependent sampling designs.