The Logics for HIV Risk Among Homeless Heroin Injectors

无家可归的海洛因注射者感染艾滋病毒风险的逻辑

基本信息

批准号：
7473081
负责人：
Philippe Bourgois
金额：
$ 24.5万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
1996
资助国家：
美国
起止时间：
1996-03-01 至 2009-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7473081
关键词：
AIDS prevention Address Adolescent Risk Behavior African American Age Aging Aging-Related Process Baby Booms Belief Birth Blood Caregivers Categories Child Class Clinic Clinical Clinical Data Clinical Research Collaborations Communication Communities Community Hospitals Comparative Study Complex Condition Daily Data Data Analyses Data Collection Data Set Demographic Aging Depth Dimensions Disease Drug Compounding Effectiveness Elderly Environment Epidemiologic Methods Epidemiologist Epidemiology Ethnic Origin Ethnography Exclusion Family Relationship Family member Funding Future Generations Gender Gender Role Generations Goals HIV Health Health Personnel Health Services Health Services Research Healthcare Hepatitis C Hepatitis C virus Heroin Homeless Youth Homelessness Income Indigenous Individual Infection Injection of therapeutic agent Institution Internet Intervention Interview Investigation Laboratories Latino Law Enforcement Life Cycle Stages Link Literature Logic Logistics Methods Modality Morals Outcome Participant Pathway Analysis Patients Pattern Peripheral Pharmaceutical Preparations Phase Physiological Positioning Attribute Prevention Prevention Research Protocols documentation Public Health Race Race Relations Rate Readiness Religion and Spirituality Report (document)Research Personnel Resources Risk Risk Behaviors Risk-Taking Running Sampling San Francisco Science Services Sexuality Site Sleep Smoker Social Network Social Power Stress Sum Time United States Ursidae Family Validity and Reliability Violence Woman Work Youth base caregiving cohort comparative cost ethnic minority population experience health care delivery improved insight intimate behavior intravenous drug user member middle age outreach preference service intervention social substance abuser

项目摘要

DESCRIPTION (provided by applicant): This project builds on six years of participant-observation ethnographic fieldwork among middle-aged homeless heroin injectors. It examines the HIV and HCV risk implications of the growing phenomenon in the United States of prematurely geriatric substance abusers by examining the aging process among both young and older injectors. The entrance into our field site of a new network of injectors who are under 30 years-old provides a natural social laboratory to document comparatively the ways the aging process changes risk of blood-borne infections and co-morbid conditions. We are contributing to a socio-culturally contextualized understanding of variance in HIV and HCV infection rates among differentially vulnerable profiles of street based IDUs that is informed theoretically at the macro-structural level. The logics for risky injection and sexual practices are examined in their larger socio-cultural and pragmatic contexts, including: 1) poly-drug abuse; 2) income-generating strategies; 3) interface with services; 4) family relations; 5) status hierarchies; 6) gender and sexuality; 7) ethnicity/race; and 8) oppositional cultural identities. A cross-generational and multi gender ethnographic team will collect qualitative data inside the shooting/sleeping encampments and income generating territory of two overlapping social networks of injectors (core N= 25-40 at any given time; peripheral N=50-70). The project extends its ongoing collaboration with epidemiologists to clinical researchers and caregivers who work with comparable data sets of injectors in San Francisco in order to engage a multi-method dialogue. An immediate applied goal is to promote communication across the research/service interface. We will offer providers of health care, outreach and treatment an indigenous perspective on the effectiveness of their services among substance abusers by age cohort through our comparative study of: 1) injectors from the baby boom generation who are advancing from mid-life to old age with rapidly deteriorating health and ongoing HIV risk; and 2) homeless youth injectors (many of whom are the children of middle-aged substance abusers) who engage in risky injection and sexual practices.

描述（由申请人提供）：该项目建立在中年无家可归的海洛因注射器中六年的参与者观察人种志实地考察。它通过检查年轻注射器和年龄较大的注射器的衰老过程，研究了美国过早老年滥用者的艾滋病毒和HCV风险影响。 30岁以下的新型注射器网络进入我们的现场网站，提供了一个自然的社会实验室，以相对记录衰老过程的方式改变血源性感染和合并症状况的风险。我们正在为社会文化的情境化理解对艾滋病毒和HCV感染率的差异的理解，这是基于街头IDU的差异脆弱概况，在宏观结构层面上是从理论上讲的。在较大的社会文化和务实的环境中检查了风险注射和性行为的逻辑，包括：1）滥用多毒物； 2）创收策略； 3）与服务的接口； 4）家庭关系； 5）状态层次结构； 6）性别和性行为； 7）种族/种族； 8）对立文化身份。一个跨代和多性别民族志团队将在拍摄/睡眠营地内收集定性数据，并在两个重叠的注射器社交网络（在任何给定时间内核心n = 25-40;外围n = 50-70）的收入产生领域。该项目将其与流行病学家的持续合作扩展到临床研究人员和护理人员，他们与旧金山的可比较数据集一起工作，以便进行多方法对话。一个直接应用的目标是促进整个研究/服务界面之间的沟通。我们将通过我们的比较研究来为虐待药物的效率提供有关其服务在滥用药物中的有效性的土著观点：1）来自婴儿繁荣产生的注射器从中期发展到老年，迅速恶化的健康和正在进行的HIV风险； 2）无家可归的青年注射器（其中许多是中年滥用者的子女），他们从事风险注射和性行为。