Keeping it together: Stigma, response, and perception of risk in relationships between drug injectors and crack smokers, and other community residents

• Published in: AIDS care Vol. 17; no. 7; pp. 802 - 813
• Main Authors: Mateu-Gelabert, P., Maslow, C., Flom, P. L., Sandoval, M., Bolyard, M., Friedman, S. R.
• Format: Journal Article
• Language: English
• Published: Abingdon Taylor & Francis Group 01-10-2005; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Addictive behaviors; Adolescent; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Cocaine; Cocaine-Related Disorders - epidemiology; Cocaine-Related Disorders - psychology; Crack Cocaine; Drug abuse; Drug abusers; Drug addiction; Drugs; Female; Health; Hispanics; HIV; HIV Infections - transmission; Human relations; Human viral diseases; Humans; Infectious diseases; Injections; Interpersonal Relations; Male; Medical sciences; Narcotics; New York; New York City; Perception; Personal relationships; Prejudice; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk; Risk Factors; Risks; Sexual Behavior; Sexually transmitted diseases; Social construction; Stereotyping; Stigmatization; Substance Abuse, Intravenous - epidemiology; Substance Abuse, Intravenous - psychology; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Surveys and Questionnaires; U.S.A; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; New York City; Brooklyn New York; Infection; Belief; Human; Immunopathology; Drug addiction; Sexually transmitted disease; Attitude; Stigma; Viral disease; Risk factor; AIDS; Immune deficiency
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540120500100486

Sexual relations between drug injectors (IDUs) and crack smokers (CS), and non-drug users are a major means of HIV spread to the broader population. However there is little literature describing community processes that regulate sexual and social partnerships among these groups. We describe these relationships in Bushwick, a low-income, mainly Latino neighbourhood in Brooklyn, NY. In this community, IDU and CS are heavily stigmatized, both by non-users and by some users. Known IDU/CS may find it harder to start and maintain social and sexual relationships, and to get jobs or support. Partially as a result of this stigma, IDU/CS attempt to 'keep it together' and hide either their drug use or its extent from other residents. Nevertheless, other residents believe, sometimes falsely, that they can distinguish users from nonusers. We describe some potential negative consequences of these beliefs and interactions, including their effects on risk for HIV and other sexually transmitted diseases.