We are more than 20 years into the HIV/AIDS epidemic. Although much is known about event-specific behaviors and contexts that facilitate HIV and HCV transmission among injecting drug users (IDUs), we know very little about the mechanisms by which many long-time IDUs have managed to remain uninfected with either virus. Given the psychological, behavioral and social problems and chaotic lives that drug injectors often face, and the ways in which these may predispose them to engage in risky behaviors in high-risk settings, it is a puzzle how some nonetheless remain uninfected over the long term.
We aim to discover strategies, resources, practices, and prevention tactics that help IDUs to remain uninfected, as well as the obstacles they face and the ways in which they overcome these obstacles. We will do this by conducting detailed life history interviews with 80 long-term current IDUs who fall into two distinct categories by infection status: (1) Doubly uninfected who are both HIV- and HCV-antibody negative; and (2) Doubly infected who are positive for both viruses. Qualitative analyses will compare and contrast the life histories of IDUs in these categories to discover how they differ in terms of strategies, socioeconomic resources, use of drug treatment and other services, and approaches to risk and risk-avoidance. Person-centered quantitative analysis methods will be used to discover additional differences between the life pathways of the two groups. We will also develop and assess a questionnaire module to measure concepts that emerge as important. This will facilitate 3 new areas of related research: 1. Epidemiologic verification; 2. Development and evaluation of prevention programs based on project findings; and 3. Etiologic research to determine physiological, psychological and social causal factors that make some IDUs more likely to implement strategies that offer a degree of long term protection from infection. This project will provide the conceptual basis for developing a new generation of HIV and HCV prevention programs to assist IDUs who are unable to quit injecting to develop strategies to avoid infection over the long run and to make better use of existing forms of prevention and treatment.
| Meylakhs, Peter; Friedman, Samuel R; Mateu-Gelabert, Pedro et al. (2015) Taking care of themselves: how long-term injection drug users remain HIV and Hepatitis C free. Sociol Health Illn 37:626-41 |
| Mateu-Gelabert, Pedro; Gwadz, Marya Viorst; Guarino, Honoria et al. (2014) The staying safe intervention: training people who inject drugs in strategies to avoid injection-related HCV and HIV infection. AIDS Educ Prev 26:144-57 |
| Friedman, Samuel R; Sandoval, Milagros; Mateu-Gelabert, Pedro et al. (2013) Theory, measurement and hard times: some issues for HIV/AIDS research. AIDS Behav 17:1915-25 |
| R Friedman, Samuel; Mateu-Gelabert, Pedro; Rossi, Diana (2012) Has United States drug policy failed? And how could we know? Subst Use Misuse 47:1402-5 |
| Vazan, Peter; Mateu-Gelabert, Pedro; Cleland, Charles M et al. (2012) Correlates of staying safe behaviors among long-term injection drug users: psychometric evaluation of the staying safe questionnaire. AIDS Behav 16:1472-81 |
| Friedman, Samuel R; Mateu-Gelabert, Pedro; Sandoval, Milagros (2011) Group sex events amongst non-gay drug users: an understudied risk environment. Int J Drug Policy 22:1-8 |
| Doerrbecker, Juliane; Friesland, Martina; Ciesek, Sandra et al. (2011) Inactivation and survival of hepatitis C virus on inanimate surfaces. J Infect Dis 204:1830-8 |
| Friedman, Samuel R; Sandoval, Milagros; Mateu-Gelabert, Pedro et al. (2011) Symbiotic goals and the prevention of blood-borne viruses among injection drug users. Subst Use Misuse 46:307-15 |
| Mateu-Gelabert, Pedro; Sandoval, Milagros; Meylakhs, Peter et al. (2010) Strategies to avoid opiate withdrawal: implications for HCV and HIV risks. Int J Drug Policy 21:179-85 |
| Friedman, Samuel R; Mateu-Gelabert, Pedro; Sandoval, Milagros et al. (2008) Positive deviance control-case life history: a method to develop grounded hypotheses about successful long-term avoidance of infection. BMC Public Health 8:94 |
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