TITLE

Positive deviance control-case life history: a method to develop grounded hypotheses about successful long-term avoidance of infection

AUTHOR(S)
Friedman, Samuel R; Mateu-Gelabert, Pedro; Sandoval, Milagros; Hagan, Holly; Jarlais, Don C. Des
PUB. DATE
January 2008
SOURCE
BMC Public Health;2008, Vol. 8 Issue 1, p94
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Prevalence rates for long-term injection drug users in some localities surpass 60% for HIV and 80% for HCV. We describe methods for developing grounded hypotheses about how some injectors avoid infection with either virus. Methods: Subjects: 25 drug injectors who have injected drugs 8-15 years in New York City. 17 remain without antibody to either HIV or HCV; 3 are double-positives; and 5 are positive for HCV but not HIV. "Staying Safe" methodology compares serostatus groups using detailed biographical timelines and narratives; and information about how subjects maintain access to physical resources and social support; their strategies and tactics to remain safe; how they handle problems of addiction and demands by drug dealers and other drug users; and how their behaviors and strategies do or do not become socially-embedded practices. Grounded theory and life-history analysis techniques compare and contrast doubly-uninfected with those infected with both viruses or only with HCV. Results: Themes and initial hypotheses emerging from analyses included two master hypotheses that, if confirmed, should help shape preventive interventions: 1) Staying uninfected is not simply a question of social structure or social position. It involves agency by drug injectors, including sustained hard work and adaptation to changing circumstances. 2) Multiple intentionalities contribute to remaining uninfected. These conscious goals include balancing one's need for drugs and one's income; developing ways to avoid drug withdrawal sickness; avoiding situations where other drug users importune you to share drugs; and avoiding HIV (and perhaps HCV) infection. Thus, focusing on a single goal in prevention might be sub-optimal. Other hypotheses specify mechanisms of enacting these intentionalities. One example is finding ways to avoid extreme social ostracism. Conclusion: We have identified strategies and tactics that some doubly-uninfected IDUs have developed to stay safe. Staying Safe methodology develops grounded hypotheses. These can be tested through cohort studies of incidence and prevention trials of hypothesis-based programs to help drug injectors make their injection and sexual careers safer for themselves and others. This positive deviance control-case life history method might be used to study avoiding other infections like genital herpes among sex workers.
ACCESSION #
51485744

 

Related Articles

  • The village/commune safety policy and HIV prevention efforts among key affected populations in Cambodia: finding a balance. Thomson, Nick; Leang, Supheap; Chheng, Kannarath; Weissman, Amy; Shaw, Graham; Crofts, Nick // Harm Reduction Journal;2012, Vol. 9 Issue 1, p31 

    The Village/Commune Safety Policy was launched by the Ministry of Interior of the Kingdom of Cambodia in 2010 and, due to a priority focus on "cleaning the streets", has created difficulties for HIV prevention programs attempting to implement programs that work with key affected populations...

  • PROSTITUTION AND HIV: WHAT YOU CANT SAY MIGHT HURT YOU. Doyle, Heather // GPSolo;May/Jun2013, Vol. 30 Issue 3, p72 

    An excerpt of the article "Prostitution and HIV: What You Cant Say Might Hurt You" in the Spring 2012 issue is presented.

  • Knowledge of the Most-at-Risk Populations about Human Immunodeficiency Virus Prevention. Ebadian, A.; Alli, V.; Sedghi, H.; Chaharborj, S. Seddighi; Fudziah, I. // American Journal of Applied Sciences;2009, Vol. 6 Issue 11, p1921 

    Problem statement: In this study we tried to assess the knowledge of general population (15-45 years), injecting drug users, female sex workers, MSM and male prisoners about HIV prevention in Iran. Approach: Respondents are asked the following set of prompted questions: (a) Can we reduce the...

  • Drug Use and High-Risk Sexual Behaviors of Women at a Drop-In Center in Mazandaran Province, Iran, 2014. Taghizadeh, Hassan; Taghizadeh, Fatemeh; Fathi, Mohammad; Reihani, Parisa; Shirdel, Nasrin; Rezaee, Seyede Mohaddese // Iranian Journal of Psychiatry & Behavioral Sciences;Jun2015, Vol. 9 Issue 2, p1 

    Background: Female drug users are more likely to transmit human immunodeficiency virus (HIV) to their sexual partners. Little is known about HIV, sexually transmitted diseases (STDs), cervicitis, and drug abuse among female sex workers in Iran. Objectives: Therefore, this study was conducted at...

  • Factors associated with history of drug use among female sex workers (FSW) in a high HIV prevalence state of India. Kumar Medhi, Gajendra; Mahanta, Jagadish; Kermode, Michelle; Paranjape, Ramesh S.; Adhikary, Rajatashuvra; Kumar Phukan, Sanjib; Ngully, P. // BMC Public Health;2012, Vol. 12 Issue 1, p273 

    Background: The intersection between illicit drug use and female commercial sex work has been identified as an important factor responsible for rising HIV prevalence among female sex workers (FSW) in several northeastern states of India. But, little is know about the factors associated with the...

  • A dose-response relationship between exposure to a large-scale HIV preventive intervention and consistent condom use with different sexual partners of female sex workers in southern India. Deering, Kathleen N.; Boily, Marie-Claude; Lowndes, Catherine M.; Shoveller, Jean; Tyndall, Mark W.; Vickerman, Peter; Bradley, Jan; Gurav, Kaveri; Pickles, Michael; Moses, Stephen; Ramesh, Banadakoppa M.; Washington, Reynold; Rajaram, S; Alary, Michel // BMC Public Health;2011 Supplement 6, Vol. 11 Issue Suppl 6, p1 

    Background: The Avahan Initiative a large-scale HIV preventive intervention targeted to high-risk populations including female sex workers (FSWs) was initiated in 2003 in six high-prevalence states in India including Karnataka. This study assessed if intervention exposure was associated with...

  • Impact of educational program on knowledge, attitude and preventive behaviors related to HIV STIs in female sex workers in Shiraz south Iran. Lari, Mahmood Amini; Sakha, Minoo Ali pour; Azra, Farbod Ebadi Far; Kazerooni, Parvin Afsar; Sayadi, Mehrab // Retrovirology;2012 Supplement 1, Vol. 9 Issue Supplment 1, p1 

    An abstract of the article "Impact of educational program on knowledge, attitude and preventive behaviors related to HIV STIs in female sex workers in Shiraz south Iran," by Mahmood Amini Lari, Minoo Ali pour Sakha, Farbod Ebadi Far Azra, Parvin Afsar Kazerooni, and Mehrab Sayadi is presented.

  • HIV prevention programmes for female sex workers in Andhra Pradesh, India: outputs, cost and efficiency. Dandona, Lalit; Sisodia, Pratap; Kumar, S. G. Prem; Ramesh, Y. K.; Kumar, A. Anod; Rao, M. Chalapathi; Marseille, Elliot; Someshwar, M.; Marshall, Nell; Kahn, James G. // BMC Public Health;2005, Vol. 5 Issue 1, p98 

    Background: Female sex workers and their clients play a prominent role in the HIV epidemic in India. Systematic data on the outputs, cost and efficiency for HIV prevention programmes for female sex workers in India are not readily available to understand programme functioning and guide efficient...

  • HIV Prevention, Treatment, and Care for People Who Inject Drugs. Larney, Sarah; Zaller, Nickolas D.; Rich, Josiah D. // Journal of Infectious Diseases;Aug2013, Vol. 208 Issue 3, p370 

    An introduction is presented in which the editor discusses a report within the issue on HIV prevention, treatment, and care services for people who inject drugs.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics