Suchergebnisse

Of the 93,000 women incarcerated in 2001, nearly 80% were mothers of approximately 130,000 minor children. Many correctional institutions have implemented programs to teach the growing number of incarcerated women effective parenting skills. However, there are few evaluations of such programs. This study examined changes in parenting attitudes as a function of program participation for drug-involved women at a correctional institution in Delaware. The attitudes of 59 women were assessed along five dimensions predictive of abusive parenting practices. Mean scores revealed no statistically significant differences between those who had completed the program, those enrolled, and those not participating. Significantly, however, standardized scores were well within average range of normed scores developed on nonabusive adult parents. Findings indicate these women did not express overly controlling or punitive attitudes with regard to children. The study lends support to other investigations documenting similarly positive parenting attitudes among substance-abusing women. Thus, the intense focus of programs on disciplinary alternatives to spanking might be misplaced.

The aims of this study were to assess the prevalence of HIV-1 infection among a group of transvestite prostitutes in Rio de Janeiro and to identify HIV-related risk behaviors to develop targeted intervention strategies. A total of 46 transvestite sex workers were recruited and assessed regarding drug use and sexual risk behaviors. Sixty-three percent tested positive for antibody to HIV-I. Injection drug use was the only factor statistically related to HIV seropositivity. However, sexual risk behaviors, including unprotected anal sex and sex for drug exchanges, were reported by a substantial part of the sample. In addition, given that they engage in both receptive and insertive anal sex with a primarily heterosexual male clientele, they may be playing a role in the heterosexual spread of HIV/AIDS in Brazil. The results of this study suggest that transvestite sex workers are at uniquely high risk for HIV infection and that intervention efforts for this population must be equally unique.

Cover -- Half Title -- Title Page -- Copyright Page -- Table of Contents -- List of Tables and Figures -- Preface -- Acknowledgments -- 1 HIV, AIDS, and Drug Use -- The Emergence of the Epidemic -- Modes of HIV Transmission -- The Global Epidemiology of HIV and AIDS -- Postscript -- 2 Brazil and the Spectrum of HIV/AIDS -- The People and Politics of Brazil -- The Sexual Culture of Brazil -- Cocaine and Other Drugs in Brazil -- HIV/AIDS in Brazil -- Postscript -- 3 Establishing an HIV/AIDS Intervention Program in a Developing Nation -- Developing the Research Protocols -- Establishing the Research Site -- Postscript -- 4 HIV/AIDS Prevention Intervention in Rio de Janeiro -- Favela and Asfalto -- Prevention Intervention -- Research Findings -- The Changing Epidemiology of HIV/AIDS in Brazil -- Limitations -- Postscript -- 5 The Female Condom and HIV Risk Reduction -- The Introduction of the Female Condom in the Americas -- The Female Condom in Brazil -- The Female Condom and the Culture of the Favelas, -- Postscript -- 6 Transvestism and HIV/AIDS in Brazil -- Cross-Dressing and Transvestism -- The Travestis of Brazil -- The Culture of Travestismo in Rio de Janeiro -- Drug Use, Sexual Behavior, and HIV/AIDS -- Feminization -- Postscript -- 7 Street Children and the Drugs/AIDS Connection -- Meninos de Rua -- The Children of the Favelas, -- Drug Use among Street Youths -- Sex and HIV Risks -- Violence Against Street Children -- Intervention Strategies -- Postscript -- 8 Epilogue: HIV/AIDS Harm Reduction Initiatives -- Harm Reduction and Injection Drug Use -- Other Harm Reduction Initiatives -- Postscript -- Appendix A: The NIDA Standard Intervention -- Appendix B: Unraveling the Concept of Race in Brazil -- References -- Index -- About the Authors

The general purposes of the PROVIVA project are to establish a community HIV/AIDS surveillance and monitoring system in Rio de Janeiro and to develop, implement, and evaluate a community-based HIV/AIDS prevention and intervention program for cocaine injectors and snorters, and male transvestite sex workers, in Rio's shantytowns, prostitution districts, and other neighborhoods where rates of street drug use are high. A secondary purpose is to develop an effective field-based HIV prevention program that can be used in other communities throughout Latin America and perhaps other developing nations. Conducting research in an international setting in general, and establishing a community-based seroprevalence and prevention project in a developing nation in particular, presented a myriad of procedural and logistical obstacles and complications. Within this context, this paper reviews the requirements of the National Institute on Drug Abuse cooperative agreement projects, examines the issues and problems associated with implementing this kind of research in a developing nation, and suggests appropriate solutions for dealing with these emergent circumstances and difficulties.

This research examined the following questions: (1) how do drug dealers acquire their inventories of prescription medications? and (2) which types of prescription medications do dealers most commonly sell? Data are drawn from a National Institute on Drug Abuse-funded research study that examined prescription drug diversion and abuse in South Florida. In-depth semi-structured interviews (n = 50) were conducted with an ethnically diverse sample of prescription drug dealers from a variety of milieus to assess patterns of diversion. Audiotapes of the interviews were transcribed, coded, and thematically analysed using the NVivo 8 software program. Dealers relied on a wide array of diversion methods including visiting multiple pain clinics, working with pharmacy employees to steal medications from pharmacies, and purchasing medications from indigent patients. The type of medication most commonly sold by dealers was prescription opioid analgesics, and to a lesser extent benzodiazepines such as alprazolam. These findings inform public health policy makers, criminal justice officials, the pharmaceutical industry and government regulatory agencies in their efforts to reduce the availability of diverted prescription drugs in the illicit market. Specifically, these data support the need for statewide prescription drug monitoring programs and increased training for healthcare workers who have access to controlled medications.