This project builds on three years of intensive participant-observation ethnographic fieldwork in the shooting encampments of a network of white and Latino homeless heroin addicts that documents the logics for HIV transmission due to syringe and ancillary paraphernalia sharing. The expansion of the core network to include a cohort of African American crack smokers and injectors has exacerbated the network's risk environment, and provides a comparative and evolving natural social laboratory that now permits the documentation in a fully indigenous setting of the ways risky injection practices articulate with: 1) ethnicity; 2) poly-drug abuse; 3) income-generating strategies; 4) gender/sexuality; and 5) status hierarchies. The restructuring of our network's boundaries and its dyadic running partnerships allows us to analyze the protective as well as risk-promoting dynamics of these socially structured relationships. We will identify network bridging and bounding mechanisms that shape the spread of HIV as well as offer contextualized processual understandings for why different individuals within the same network and across comparable networks engage in distinct patterns of risky injection behavior. A multi-ethnic research team will collect the data inside the shooting and sleeping encampments of the core network of 20 heroin injectors and their peripheral social contacts (approximately 50 additional injectors). The research design and analysis links theoretically significant categories addressing macro-social power relations to the specific observable risky behaviors of differentially vulnerable individuals. An analysis of the pragmatics and contexts for taboo behaviors that are sometimes concealed or misreported to outsiders offers public health service providers an indigenous perspective on the effectiveness of their outreach programs. The project engages a methodological dialogue without long-term epidemiological cohort studies of IDUs in order to operationalize qualitative data into testable epidemiological constructs. This ongoing iterative dialogue also allows us to reframe questions, generate new hypotheses, and systematize sampling strategies among out-of-treatment, hard-to-reach substance users. The long-term goal is to contribute to a socially contextualized model that explains variance in HIV infection/risk-behavior rates among different vulnerable sectors of the U.S. population by elucidating the social forces--both micro and macro -- that shape the spread of blood-bone disease among injectors.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA010164-06
Application #
6620213
Study Section
Special Emphasis Panel (ZRG1-AARR-7 (02))
Program Officer
Lambert, Elizabeth
Project Start
1996-03-01
Project End
2004-02-29
Budget Start
2003-03-01
Budget End
2004-02-29
Support Year
6
Fiscal Year
2003
Total Cost
$319,367
Indirect Cost
Name
University of California San Francisco
Department
Social Sciences
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Bourgois, Philippe (2018) Decolonising drug studies in an era of predatory accumulation. Third World Q 39:385-398
Branas, Charles C; South, Eugenia; Kondo, Michelle C et al. (2018) Citywide cluster randomized trial to restore blighted vacant land and its effects on violence, crime, and fear. Proc Natl Acad Sci U S A 115:2946-2951
Bluthenthal, Ricky N; Chu, Daniel; Wenger, Lynn D et al. (2018) Differences in time to injection onset by drug in California: Implications for the emerging heroin epidemic. Drug Alcohol Depend 185:253-259
Bluthenthal, Ricky N; Wenger, Lynn; Chu, Daniel et al. (2017) Drug use generations and patterns of injection drug use: Birth cohort differences among people who inject drugs in Los Angeles and San Francisco, California. Drug Alcohol Depend 175:210-218
Bourgois, Philippe; Holmes, Seth M; Sue, Kim et al. (2017) Structural Vulnerability: Operationalizing the Concept to Address Health Disparities in Clinical Care. Acad Med 92:299-307
Culyba, Alison J; Jacoby, Sara F; Richmond, Therese S et al. (2016) Modifiable Neighborhood Features Associated With Adolescent Homicide. JAMA Pediatr 170:473-80
Bourgois, Philippe; Hart, Laurie Kain (2016) [Pax Narcotica : The Open-Air Drug Markets of Philadelphia's Puerto Rican Inner City]. Homme 3:31-62
Mars, Sarah G; Bourgois, Philippe; Karandinos, George et al. (2016) The Textures of Heroin: User Perspectives on ""Black Tar"" and Powder Heroin in Two U.S. Cities. J Psychoactive Drugs 48:270-8
Wenger, Lynn D; Lopez, Andrea M; Kral, Alex H et al. (2016) Moral ambivalence and the decision to initiate others into injection drug use: A qualitative study in two California cities. Int J Drug Policy 37:42-51
Branas, Charles C; Kondo, Michelle C; Murphy, Sean M et al. (2016) Urban Blight Remediation as a Cost-Beneficial Solution to Firearm Violence. Am J Public Health 106:2158-2164

Showing the most recent 10 out of 64 publications