Symbiotic Goals and the Prevention of Blood-Borne Viruses Among Injection Drug Users

Abstract

A positive-deviance control–case life history study of injection drug users (IDUs) in New York City who had injected drugs for 8–15 years compared 21 IDUs who were antibody negative for both HIV and hepatitis C with 3 infected with both viruses and 11 infected with hepatitis C virus but not HIV. Eligible subjects were referred from other research studies and from community organizations that conduct testing for HIV and hepatitis C virus. Data were collected during 2005–2008 and were analyzed using life history and grounded theory approaches. They support grounded hypotheses that IDUs who are able to attain symbiotic goals like avoiding withdrawal and maintaining social support are assisted thereby in remaining uninfected with HIV or hepatitis C. These hypotheses should be tested using cohort studies and prevention trials to see if helping IDUs attain symbiotic goals reduces infection risk. The study's limitations are noted.

Keywords :

• HIV
• hepatitis C
• prevention
• injection drug user
• positive deviance
• symbiotic goals
• structural interventions

THE AUTHORS

Samuel R. Friedman, Ph.D., sociologist, is a Senior Research Fellow at the National Development and Research Institutes, Inc. (New York, USA) and the Director of the Interdisciplinary Theoretical Synthesis Core at the Center for Drug Use and HIV Research. Dr. Friedman is an author of over 350 publications on HIV, STI, and drug use epidemiology and prevention.

Milagros Sandoval, B.A., Ethnographic Data and Analysis Coordinator, has worked at the National Development and Research Institutes, Inc. (New York, USA), since 1996 and has more than 15 years of community work experience.

Pedro Mateu-Gelabert, Ph.D., is a sociologist with 15 years’ experience doing qualitative research in New York City. He is currently Co-Investigator and Project Director at the National Development and Research Institutes, Inc. (New York, USA).

Peter Meylakhs, Ph.D., is a Research Fellow at the Centre for Independent Social Research in St. Petersburg, Russia.

Don C. Des Jarlais, Ph.D., is Director of Research for the Baron Edmond de Rothschild Chemical Dependency Institute at Beth Israel Medical Center and Professor of Epidemiology and Social Medicine at the Albert Einstein College of Medicine in New York. He is one of the leading authorities on AIDS and intravenous drug use and has published extensively on these related topics.