SEX, DRUGS, AND THE SPREAD OF HIV AIDS IN BELLE-GLADE, FLORIDA

Belle Glade, Florida, an agricultural community in the heart of the st ate's vegetable and sugar cane production areas, has the highest cumul ative per capita incidence of AIDS in the United States. A risk reduct ion intervention program was introduced to lessen unsafe AIDS-related behaviors and to generate data on the epidemiology of HIV infection. I nitial attention focused on individuals who were believed to be at the core of the transmission pattern, injection drug users and their sexu al partners. We found, however, that injection drug use was much less widespread than anticipated. Results suggested that the primary mode o f HIV transmission is heterosexual intercourse-mediated by drug taking (particularly crack smoking) and a flourishing sex industry-a finding that is corroborated by the increased and disproportionate rate of he terosexual AIDS in Belie Glade. The prevalence and types of risk behav iors engaged in would not have been completely explained without the u se of ethnographic methods including observation of and lengthy interv iews with, the populations at risk.