Background: Analyses of the individual-, social- and structural-level factors promoting the transmission of HIV and other blood-borne pathogens have consistently identified exposure to correctional environments, especially for individuals who use injection drugs (IDU), as a risk factor for infection. The objectives of this project were: to review the epidemiologic literature on incarceration and HIV infection among IDU, critically examining evidence presented supporting a causal linkage between imprisonment and infection; to investigate incarceration experiences in a cohort of active IDU; and to assess the possible effects of incarceration on the post-release risk environment of active IDU. Methods: Longitudinal datasets for quantitative analyses were derived from the Vancouver Injection Drug User Study (VIDUS) and the Scientific Evaluation of Supervised Injection (SEOSI), both prospective cohorts of IDU in Vancouver’s Downtown Eastside neighbourhood. In the first analysis, the prevalence and correlates of reporting incarceration in the the previous six months were identified in SEOSI using generalized estimating equations (GEE). In the second analysis, the possible effect of imprisonment on the prevalence of risk factors for HIV infection was estimated in VIDUS using linear growth curve analysis. Results: In the first analysis, 902 individuals interviewed at least once between 1 July 2004 and 30 June 2006 were included. Overall, 423 (46.9%) reported an incarceration event at some point during the study period. In a multivariate GEE model, recent incarceration was independently associated with a number of high-risk factors, including syringe sharing. In the second analysis, 1603 individuals were interviewed at least once between 1 May 1996 and 31 December 2005 and in cluded. Of these, 147 (9.2%) matched the study criteria and were included as cases; 742 (46.3%) were included as matched controls. In linear growth curve analyses adjusted for age, gender and ethnicity, syringe sharing was significantly more common in the incarcerated group (p = 0.03) after incarceration than in the control group. Conclusions: Our findings support the existence of a role for incarceration in continued viral transmission. In response, appropriate harm reduction measures should be expanded within correctional environments and social, political and legal reforms enacted to reduce the incidence of imprisonment for individuals who use illicit drugs.

No description available.

The thesis was designed to determine the nature, type, and scope of drug use existing on the Ball State University Campus. An anonymous questionnaire was administered to a ten percent stratified random sample of undergraduate students with a proportional allocation of ten percent from each of the four college years.Results of the survey revealed drug use (use for other than medically prescribed reasons) by 31.5 percent of the sample. Ball State students who used drugs were likely: To be 21 to 22 years of age, to be males, to be juniors, to major in the Science of Humanities, to be divorced, to specify “none” for religious affiliation, to live in off-campus unapproved housing, to have a grade point average of 1.5 to 2.0, to have parents with incomes of $15,000-$20,000, to have begun their use of drugs as college sophomores, to have received their first drugs from friends, to have used, to be currently using, and to anticipate continuing to use the drug, marijuana, and to give curiosity as their main reason for using drugs.

No description available.

In an effort to shift away from the narrow medical model of drug treatment the Advisory Council on the Misuse of Drugs (ACMD), in 1982, introduced the idea of the 'problem drug user' (PDU) and recommended a multi-disciplinary approach in order to meet the increasingly evident multiple and complex problems presented by dependent drug users. However, despite the development of a series of drug strategies (HM Government, 1995; 1998; 2002; 2008; 2010) and vast increases in funding, dependent drug users are still struggling to receive the services they require to address their diverse problems (Neale, 2008; Buchanan, 2010). Through an analysis of in-depth interviews with dependent drug users and their keyworkers this thesis seeks to explain these deficiencies. The author argues that the broad umbrella of drug policy that has adopted a framework of risk-based strategies to regulate and control drugs and drug users has focused on the social and economic costs associated with problem drug use, particularly in relation to the belief that much acquisitive crime is drug-related. Hence, the focus has not been on the problems that drug users have but on the problems they cause. The medical model that has dominated the treatment of addiction has been reinforced, therefore, not only because 'drug addiction' has been described as a chronic and relapsing condition (NTA, 2002), but also because of the wider social control objectives (crime reduction, in particular) that this approach delivers (Lind et al., 2005; Gossop, 2005; Millar et al., 2008). The author examines the implications of these drug policy directions on the treatment journeys of dependent drug users. Firstly, the author demonstrates how the confluence of the health and crime reduction agendas has led to the paradoxical perception of drug users as being 'sick-but-deviant' that has served to exacerbate their stigmatised identities. Secondly, the author suggests that the closer alignment between the drug treatment workforce and the criminal justice system has led to the isolation of drug treatment from wider health and social care services. Together, these two consequences of drug policies have created further barriers to service access and successful recovery, thereby providing an explanation for the unmet need of dependent drug users attending treatment services.

The contribution of this research is in the area of adolescent decision making. The specific decision examined is the decision to use or not use drugs. Several factors were expected to have significant impacts on this crucial adolescent decision. These factors included peer, school, family, and religion influences. The source of the data was a sample of ninth through twelfth grade students in a north Texas city. The students responded to a survey questionnaire in the spring semester of 1989. A total of 632 students responded to the questions about alcohol- and drug-related attitudes, beliefs, and behaviors. Four major hypotheses were tested, and each one was supported by the research findings. In the first hypothesis, it was expected that family drug use factors would have a positive effect on adolescent drug use. Family factors included the following: parental use of alcohol, problems for family members due to parental drinking, and problems for the respondent due to parental drinking. Family factors had a statistically significant effect on alcohol use and any drug use.

Background: Analyses of the individual-, social- and structural-level factors promoting the transmission of HIV and other blood-borne pathogens have consistently identified exposure to correctional environments, especially for individuals who use injection drugs (IDU), as a risk factor for infection. The objectives of this project were: to review the epidemiologic literature on incarceration and HIV infection among IDU, critically examining evidence presented supporting a causal linkage between imprisonment and infection; to investigate incarceration experiences in a cohort of active IDU; and to assess the possible effects of incarceration on the post-release risk environment of active IDU. Methods: Longitudinal datasets for quantitative analyses were derived from the Vancouver Injection Drug User Study (VIDUS) and the Scientific Evaluation of Supervised Injection (SEOSI), both prospective cohorts of IDU in Vancouver’s Downtown Eastside neighbourhood. In the first analysis, the prevalence and correlates of reporting incarceration in the the previous six months were identified in SEOSI using generalized estimating equations (GEE). In the second analysis, the possible effect of imprisonment on the prevalence of risk factors for HIV infection was estimated in VIDUS using linear growth curve analysis. Results: In the first analysis, 902 individuals interviewed at least once between 1 July 2004 and 30 June 2006 were included. Overall, 423 (46.9%) reported an incarceration event at some point during the study period. In a multivariate GEE model, recent incarceration was independently associated with a number of high-risk factors, including syringe sharing. In the second analysis, 1603 individuals were interviewed at least once between 1 May 1996 and 31 December 2005 and in cluded. Of these, 147 (9.2%) matched the study criteria and were included as cases; 742 (46.3%) were included as matched controls. In linear growth curve analyses adjusted for age, gender and ethnicity, syringe sharing was significantly more common in the incarcerated group (p = 0.03) after incarceration than in the control group. Conclusions: Our findings support the existence of a role for incarceration in continued viral transmission. In response, appropriate harm reduction measures should be expanded within correctional environments and social, political and legal reforms enacted to reduce the incidence of imprisonment for individuals who use illicit drugs. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

Research targeting the chemically dependent woman has received little attention, even though the research indicates a convergence of male and female drinking norms. Research centered on the special issues of the chemically dependent woman also needs to be extended beyond the scope of actual alcohol and drug abuse and resulting treatment to include information on what issues women face in their recovery process. The findings would help treatment providers design more successful interventions for this population. This study used qualitative methods to investigate issues that 12 chemically dependent women, ranging in actual time in recovery from first to third year post inpatient treatment, discussed as part of a 16 week therapy group. Their recorded responses were transcribed and analyzed, using Glaser and Strauss' methods of comparative analysis, comparing the women between three groups desiginated by the divisions of first, second, and third year post inpatient treatment. The findings indicate that all share many of the same issues, however there are marked differences between the groups. All the women had difficulties with intra- and interrelationships, finding it difficult to maintain a healthy recovery in spite of the problems they confronted in experiencing reality without mind-altering substances. Many issues were influenced by the subjects' family of origin history and sex-role orientation. Conflicts in role obligations resulting in work, family, parenting, and relationship problems surfaced. All the women were aware of additional substance and compulsive dependencies that they would like to eliminate; however, avoiding relapse of their alcohol/drug addiction was the major concern for most. The findings reveal that the longer women spent time actively undertaking a concerted program of recovery, the more they experienced integration into the rest of society, and that the acquisition of life skills and resolution of the past were important factors to the success of this integration. The categories and theme issues that emerged from the analysis have implications for social work practice, policy, and further research. / Arts, Faculty of / Social Work, School of / Graduate

archives@tulane.edu / Background: Although engagement and retention in HIV care and treatment is a critical issue across populations, it is of particular importance among female sex workers (FSWs) as they are disproportionately affected by HIV due to high rates of sexual risk behaviors and large sexual networks. Drug use is one of the most consistent and salient barriers to successful engagement in HIV care and treatment. For many FSWs, drug use is a common part of their daily lives. While individual-level factors likely explain a substantial portion of variability in drug use behavior, evidence demonstrates that differences in health behaviors and outcomes cannot be fully explained by individual-level factors alone. Previous explorations of drug-related harms have found that neighborhoods and social networks are two important environments that impact substance use behavior and associated health outcomes; yet, there has been little research on the interacting effects of networks and neighborhoods on drug use among FSWs living with HIV. Objective: Using innovative geospatial and social network methods, the purpose of this pilot study was 1) to characterize the physical and social risk environments of a small cohort of FSWs living with HIV in the Dominican Republic (DR), and 2) to examine the association between their daily activity patterns and social relationships on illicit drug use. Methods: A micro-longitudinal observational study design was employed. Data collection activities included: (1) semi-structured questionnaire, (2) daily activity space mapping, (3) daily behavior diary, (4) social network survey; and (5) secondary data. Statistical analysis included spatial mapping, social network analysis, univariate and bivariate means analysis, generalized estimating equations (GEE) with repeated measures, interaction and effect modification. Results: Findings suggest that social networks, specifically drug networks and sex and drug networks, and daily activity path and location-based risk exposures are independently associated with risk of daily drug use, and that network risk profile modifies the association between location-based risk exposure and daily drug use. Results from Paper 1 show that participants exposed to a higher number of risk outlets within 200 meters of their weekly activity paths weighted by time exposed had an increased risk of daily drug use (RRadj: 2.83, 95%CI: 1.14, 7.03). Similarly, per unit increase in risk outlet exposure within 200 meters of sex work locations was associated with an increased risk of daily drug use (RRadj: 1.03, 95%CI: 1.00, 1.05). Paper 2 results indicate that participants with more drug using members and sexual partners who were also drug users in their social networks were 8.89 (95%CI: 2.62, 30.33) and 6.08 (95 CI%: 1.20, 30.92) times more likely to use drugs compared to those with fewer drug using members and sexual partners who used drugs. Finally, paper 3 results suggest that the joint effects of networks and activity space are greater than individual effects alone and that drug network and sex and drug network modify the association between sex work location risk environment exposure and daily drug use. No differences were detected among individuals with large drug and sex and drug networks, but among individuals with small drug and sex and drug networks, per unit increase in risk outlet exposure within 200-meters of sex work locations was associated with an increased risk of daily drug use. Conclusions: This research provides significant information on the overlapping and diverging characteristics of the social factors and physical spaces that shape drug use in the broader context of sex work, HIV, and vulnerability in a low-and middle-income country (LMIC) setting. Findings may be used to inform integrated care interventions that are geographically targeted and address the social processes and structures that influence drug harms and HIV treatment in a highly stigmatized and vulnerable population. / 1 / Erica Ann Felker-Kantor

In this paper we will discuss our unsuccessful attempt to conduct a self-report study of delinquent behavior in an urban multi-racial high school in Portland, Oregon. Much of this report reflects our preparation in conducting a self-report study and our analysis of why if failed. The contention of this study is that delinquent behavior, and not juvenile delinquency is the major problem facing youth serving agencies and the public. The purpose of this study is an attempt to refine an often used method of measuring delinquent behavior – the self–report. Favoring a self–report technique of data collection rather than an analysis of rate variations, a comparison of matched samples or a study of subcultures, tends to ground this study in a “radical non-intervention” approach to the field of delinquent behavior. This particular approach views delinquent behavior as widespread throughout society rather than concentrated among the economically disadvantaged or in a certain subculture of the adolescent population.