Places of risk: The spatiality of drug use patterns and its applicability for targeted recruitment of out -of -treatment injecting drug users

• Main Author: Negron-Ayala, Juan L
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2008
• Subjects: Disease prevention; Drug use; Forensic anthropology; HIV; Human immunodeficiency virus; Public health; Risk factors
• ISBN: 0549811265; 9780549811268

This dissertation explores the intersection between space and risk behavior patterns and how the understanding of this relationship could be applied to HIV prevention initiatives. I organize the discussion around two major components: (1) describing the application of an ethno-geographic multi-method approach to develop indicators of high-risk drug-related activities and (2) a more purely ethnographic endeavor, focusing on how drug use patterns are embedded in and sustained by spatial relations and meanings of place. The first component's main goal is to analyze the design and the outcomes of a targeted recruitment strategy to locate and recruit active out-of-treatment injecting drug users (OTIDUs) for a city-wide HIV prevention research in Philadelphia, PA. This task combined ethnographic methods with spatial analysis techniques. On the one hand, I used ethnographic methods to identify networks of OTIDUs, and to describe their practices and the context where they happen. On the other hand, I employed spatial analysis techniques to create a composite picture of drug-related risk activities, which simultaneously allowed visualizing and interpreting spatial patterns of drug-related risk activities and exploring their relationship with epidemiological, demographic and ethnographic information. The goal of the second component is to situationally ground explanations on risk behaviors and practices in a local context exploring the mediation of urban configuration on the process by which space achieves identity as a place of risk. I suggest an alternative reading of risk behavior contexts as local and immediate, where risk behaviors and practices, especially drug use and selling, happen not as events but as a trajectory that flows with and in the urban space. I conclude that it is methodologically and theoretically critical to adjust the research gaze to de-camouflage the “illusionary transparency” of this spatio-behavioral co-presence to make visible for HIV/AIDS prevention initiatives those individuals engaged in high-risk drug-related activities, especially the ones outside the institutional settings and concealed from agencies of social control.