Approximately half of injecting drug users (IDUs) and a quarter of crack smokers in New York City are infected with HIV. In """"""""high-risk"""""""" neighborhoods with large concentrations of IDUs and crack smokers, this may pose a serious threat of sexual transmission of HIV to youth. Pilot data indicate that many such youth engage in unprotected sex with multiple partners and that they have very high rates of sexually transmitted diseases. We need to know which youth are most likely to have sex with IDUs and crack smokers, and thus to be at high risk for becoming infected with HIV; and which youth, in turn, are likely to have sex with the sex partners of IDUs and crack smokers. Youth who use heroin or cocaine (but who neither inject drugs nor smoke crack) may be very likely to have sex with IDUs and crack smokers, and, as a result, to be infected with HIV, hepatitis B, hepatitis C, and perhaps other STDs. (ln the pilot study, 79% of them were infected with herpes simplex virus type 2).
Specific aims are to ascertain the prevalence among youth in a high-risk neighborhood of: (1) each drug-usage pattern; (2) high-risk sexual behaviors and high-risk sexual networks, and how these vary by drug-usage category; (3) infection with HIV, HBV, HCV and other STDs, and how these vary by drug-usage category. Also, (4) to determine social and personal risk factors for involvement in higher-risk drug usage, high-risk sexual behavior and high-risk sexual networks, and for HIV, its surrogate markers, and STDs. Since a pilot study indicated that many youth may have drug-use-resistant norms and attitudes, we aim to (5) determine the prevalence, determinants and behavioral effects of such norms and attitudes. (6) Available datasets on HIV prevalence and drug use among youth will be used to estimate the national generalizability of the findings on the prevalence of HIV and of drug-usage patterns. To answer these questions, a cross-sectional survey, including HIV and other testing, will be conducted of two samples of 18 to 24 year old youth in a high-risk Brooklyn neighborhood: (1) a probability sample of 700 household youth; (2) a targeted sample of 350 high-risk local youth who inject drugs or use crack, other cocaine, or heroin. Ethnographic research will study sexual relationships of these youth and the social and cultural forces that support and undermine youthful resiliency against high-risk sex and drug use. These findings can help target interventions where they are most needed and develop strategies to prevent high-risk drug use, high-risk sex, and infection with HIV.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA010411-04
Application #
2898044
Study Section
Special Emphasis Panel (SRCD (24))
Program Officer
Obrien, Moira
Project Start
1996-07-01
Project End
2001-06-30
Budget Start
1999-07-01
Budget End
2001-06-30
Support Year
4
Fiscal Year
1999
Total Cost
Indirect Cost
Name
National Development & Research Institutes
Department
Type
DUNS #
City
New York
State
NY
Country
United States
Zip Code
10010
Friedman, Samuel R; Mateu-Gelabert, Pedro; Curtis, Richard et al. (2007) Social capital or networks, negotiations, and norms? A neighborhood case study. Am J Prev Med 32:S160-70
Kottiri, Benny J; Friedman, Samuel R; Euler, Gary L et al. (2005) A community-based study of hepatitis B infection and immunization among young adults in a high-drug-use neighborhood in New York City. J Urban Health 82:479-87
Mateu-Gelabert, P; Maslow, C; Flom, P L et al. (2005) Keeping it together: stigma, response, and perception of risk in relationships between drug injectors and crack smokers, and other community residents. AIDS Care 17:802-13
Friedman, Samuel R; Flom, Peter L; Kottiri, Benny J et al. (2003) Drug use patterns and infection with sexually transmissible agents among young adults in a high-risk neighbourhood in New York City. Addiction 98:159-69
Friedman, S R; Flom, P L; Kottiri, B J et al. (2002) Consistent condom use among drug-using youth in a high HIV-risk neighbourhood. AIDS Care 14:493-507
Friedman, S R; Flom, P L; Kottiri, B J et al. (2001) Consistent condom use in the heterosexual relationships of young adults who live in a high-HIV-risk neighbourhood and do not use ""hard drugs"". AIDS Care 13:285-96
Flom, P L; Friedman, S R; Kottiri, B J et al. (2001) Stigmatized drug use, sexual partner concurrency, and other sex risk network and behavior characteristics of 18- to 24-year-old youth in a high-risk neighborhood. Sex Transm Dis 28:598-607
Friedman, S R; Flom, P L; Kottiri, B J et al. (2001) Prevalence and correlates of anal sex with men among young adult women in an inner city minority neighborhood. AIDS 15:2057-60
Friedman, S R; Wainberg, M A; Drucker, E (1998) Therapeutic ethics and communities at risk in the presence of potential mutation to resistant strains to HIV antiviral medications. AIDS 12:2089-93
Friedman, S R; Curtis, R; Jose, B et al. (1997) Sex, drugs, and infections among youth. Parenterally and sexually transmitted diseases in a high-risk neighborhood. Sex Transm Dis 24:322-6