CONTEXT: Condoms are less likely to be used in primary relationships than other relationship types. An understanding of what women and men expect when entering into these relationships, as well how they make decisions about condom use prevention behaviors, is essential eff orts curb the spread HIV. METHODS: Qualitative in‐depth interviews were conducted with 25 high‐risk heterosexual couples, including HIV‐serodiscordant participating a trial female Hartford 2004–2007. Data codedand analyzed...

Opioid use disorder (OUD) through prescription opioid misuse, heroin, and illicitly manufactured fentanyl has increased dramatically in the past 20 years. Medications to treat (MOUD) is considered gold standard for treating disorders but uptake remains low. Recently, Madden argued that addition stigma assigned substance people with SUD, MOUDs also are stigmatized, a process she labels intervention distinguish it from condition (ie, of SUD) . In this paper, we examine MOUD related perspective...

Drawing on the tenets of critical medical anthropology, this article illustrates relation between violence, drug use, prostitution, and HIV risk in a group 35 impoverished women living inner-city Hartford, Connecticut. The study presented here provides an illustration role prostitution plays SAVA (Substance Abuse, Violence, AIDS) syndemic as conceptualized by Singer (1996). By focusing life experiences engaged street-level attempts to fill gaps research that deals simultaneously with these...

Abstract Introduction The United States is currently facing an opioid overdose crisis. Research suggests that multiple interventions are needed to reduce deaths including increasing access and retention medications treat use disorders (MOUD, i.e., methadone, buprenorphine, naltrexone) the distribution of naloxone, a medication can reverse respiratory depression occurs during overdoses. However, barriers MOUD initiation persist discontinuations carry heightened risk overdose. Many times, not...

AbstractThe Risk Avoidance Partnership (RAP) Project conducted in Hartford, Connecticut, tested a program to train active drug injectors and crack cocaine users as "Peer Health Advocates" (PHAs) deliver modular HIV, hepatitis, STI prevention intervention hard-to-reach their networks others the city. The was designed diffuse health promotion risk-reduction interventions by supporting PHAs model practices risk- harm-reduction materials information. We compared change behaviors attitudes...

People who use drugs (PWUDs) in the United States historically have had a higher probability of being uninsured. Passage Affordable Care Act, Paul Wellstone and Pete Domenici Health Parity Addiction Equity was expected to increase access treatment for substance disorder. Few studies date conducted qualitative research with disorder (SUD) providers regarding Medicaid other insurance coverage SUD following passage ACA parity laws. The present paper fills this gap by reporting data from...

Drug addicted women whose economic and social base is urban streets face limited options for income generation multiple dangers of predation, assault, arrest, illness. Exchanging sex money or drugs offers one important source in this context. Yet the legal, social, safety risks associated with these exchanges reduce likelihood regular safer practices during encounters, thereby increasing risk HIV infection. Such conditions lead engaged sexual to varied complex responses influenced by often...

Abstract Peer delivered, social oriented HIV prevention intervention designs are increasingly popular for addressing broader contexts of health risk beyond a focus on individual factors. Such interventions have the potential to affect multiple levels and change, including at individual, network, community levels, reflect ecological principles interaction across over time. The iterative feedback dynamic generated by this multi‐level effect increases likelihood sustained improvement initiated...

This study investigated the mechanisms of risk for urban women at high HIV with and without childhood sexual abuse histories. Childhood survivors reported more unprotected intercourse sexually transmitted infections (STIs). The association STI locus control frequency sex was fully mediated by being intoxicated during engaging in work, whereas between relational not contextual factors group. are different those divergent histories thus interventions should be developed to educate a history...

Project RAP (Risk Avoidance Partnership) trained 112 active drug users to become peer health advocates (PHAs). Six months after baseline survey (Nbl = 522), 91.6% of PHAs and 56.6% community adopted the innovation giving intervention, 59.5% all participants (N6m 367) were exposed innovation. Sociometric network analysis shows that adoption exposure was associated with proximity a PHA or highly interventionist (HAI), being directly linked multiple PHAs/HAIs, located in sector where PHAs/HAIs...

Highlights Participatory system dynamics modeling helps improve the HIV service to reduce epidemic. We engaged local stakeholders critique their using modeling. Participants showed enhanced communication and consensus about systems understanding solutions.

Prescription Drug Monitoring Programs (PDMPs) were designed to curb opioid misuse and diversion by tracking scheduled medications prescribed medical providers dispensed pharmacies. The effects of PDMPs on prescription, overdose rates have been mixed due in part variability states' difficulties measuring this complexity, a lack attention implementation enforcement PDMP components. current study uses qualitative interviews with key informants from 3 states different PDMPs, Connecticut,...

The objectives of this study were to measure microbicide acceptability among high-risk women in Hartford, Connecticut, and contextual factors likely affect use.The goal was assess usefulness microbicides for HIV/sexually transmitted infection (STI) prevention women.Ethnographic interviews (n = 75) a survey 471) explored women's perspectives on HIV/STI prevention, vaginal contraceptives similar microbicides, acceptability. Participants 94) 2-week behavioral trial used an over-the-counter...

The purpose of this study is to illuminate the experiences lower income, urban, HIV-positive drug users. authors asked 60 participants about HIV risk behaviors, impact on their lives, religious beliefs, life plans, relationships, and work-related issues both prior since diagnosis. They developed a theoretical framework based illness narratives ambiguous loss theories. Themes pertaining physical emotional or spiritual dimensions were located within Benefit, Loss, Status Quo orientations....

This paper examines the relationship between housing status and HIV risk using longitudinal, qualitative data collected in 2004–2005, from a purposeful sample of 65 active drug users variety housed homeless situations Hartford, Connecticut. These were supplemented with observations in-depth interviews regarding use behavior 2001–2005 to evaluate peer-led prevention intervention. Data reveal differences social context within among different statuses that affect or protective behaviors...

This article analyzes data on drug injection frequency in a sample of more than 13,000 out-of-treatment injectors interviewed across 21 U.S. cities and Puerto Rico through the National Institute Drug Abuse (NIDA) Cooperative Agreement for AIDS Community-Based Outreach/Intervention Research Program. The goals are to present findings predict variation terms set variables suggested by previous research, including location, ethnicity, gender, age, educational attainment, years since first use...

Here we present results from a process evaluation of peer-led HIV prevention intervention. The Risk Avoidance Partnership, conducted 2001 to 2005, trained active drug users be peer health advocates (PHAs) provide harm reduction materials and information their peers. Results indicate that PHAs actively outreach both when partnered with staff on own time. Although most in public locations, they also provided at critical moments places where risky behaviors were likely occur. credible trusted...

Efforts have expanded to create AIDS prevention programs for drug users that consider the social context and interpersonal relationships within which risky practices take place. The Risk Avoidance Partnership (RAP) project is designed train active as "Peer/Public Health Advocates" (PHAs) bring a structured, peer-led intervention into sites where they their drug-using networks use illicit drugs. RAP Peer Advocacy training curriculum promote harm reduction among support drug-user organization...

Much research has shown that the homeless have higher rates of substance abuse problems than housed populations and increases individuals' vulnerability to homelessness. However, effects housing policies on drug users' access been understudied date. This paper will look at "unofficial" affect housing.Qualitative interviews were conducted with 65 active users heroin cocaine baseline, 3 6 months. Participants purposively sampled reflect a variety statuses including streets, in shelters,...