Communication about health issues such as HIV/AIDS is essential for people, especially women, to obtain the social support they need either to prevent illness or manage it. This article compares the kinds of HIV-related issues that HIV positive and HIV negative substance-abusing women (N=211) in New York City talk about with various types of supporters. Despite the stigma associated with AIDS and their unconventional lifestyles, both groups of women talked to a broad spectrum of supporters about a variety of HIV-related issues, though this was more the case for HIV positive women. Although the main topic that both groups discussed with their supporters was their HIV status, the women also talked about risk reduction, their supporters' HIV status, HIV testing, how to live with AIDS, information about HIV/AIDS, and the emotional impact of AIDS (e.g., fear of infection, reactions to learning test results, and the impact of knowing others who have died from the disease).
Many HIV positive drug users are unaware that they have the virus, either because they never obtained testing for HIV or because they submitted a biological specimen for testing but never returned to obtain the result of the test. Using data collected from a large multi-site sample of out-of-treatment HIV positive drug users (N=1,544), we identify a variety of socio-demographic characteristics and drug use and sexual risk behaviors that differentiate HIV-positive individuals who had obtained HIV testing in the past and those who had not and, among those who had been tested, what differentiates individuals who had returned to obtain their HIV test results and those who had failed to return. Results of the analyses suggest that there is a need to target different subgroups of high risk drug users for interventions to obtain HIV testing as compared with those that need encouragement to obtain the results of this testing.
This paper uses qualitative methods to examine both staff and clients' perceptions about the delivery of hepatitis C prevention education services at their respective residential drug treatment programs. Through in-depth discussion with participants, as well as program observation, we elicited clients' and staff attitudes about the role that drug treatment programs can play in providing prevention education services for hepatitis C, their evaluation of existing hepatitis C prevention education services, and recommendations for enhancing future services. Although participants identified limitations to services, most perceive that treatment programs can play an important role in hepatitis C prevention education service delivery. Participants view clients' misconceptions about hepatitis C, increased disease stigma, and diminished service utilization as potential consequences of limited hepatitis C prevention education services. Recommendations for improving services include more detailed and frequent opportunities for hepatitis C education, formalizing services, offering education in multiple formats, and providing additional staff training.
Injection drug users (IDUs) face an increased risk of acquiring blood borne viral infections, including HIV and the hepatitis C virus (HCV). However, the discrepancy in funding for services to address these two diseases has implications. Although drug treatment programs have played an important role in fighting HIV/AIDS, the HCV-related services offered at these programs remain limited. Research from other countries suggests that drug users view HCV as less important than HIV, yet little is known about the extent to which our society's focus on HIV has been adopted within the drug treatment program culture. This qualitative study examines the perceptions of both staff (n = 165) and clients (n = 215) at these programs with regard to HIV and HCV and presents data on how staffs' attitudes toward HCV changed after participating in an HCV training. Clients described a services landscape at drug treatment programs that favors HIV services over those targeting HCV.
Given the high prevalence of hepatitis C virus (HCV) infection among drug users, HCV testing is critical in this population. While many drug treatment programs offer HCV testing, patients often do not utilize this essential program-facilitated service. Summarizing data collected in semi-structured interviews and surveys with patients in 25 programs, this paper identifies barriers and facilitators to being tested for HCV through the program. Barriers include the patient's belief that she/he is not HCV infected, fear of needles, fear of obtaining a positive HCV test result, fear of disclosure of such a result, and fear of inappropriate or disrespectful treatment during the testing process. In addition, 38% of HCV sero-unaware or sero-negative patients completing the survey did not know that HCV testing was offered through their programs. Salient facilitators for those tested through their programs include support from staff in explaining the importance of testing and help in understanding and coping with test results.