High risk drug use sites, meaning and practice: Implications for AIDS prevention

A study of drug use locations in Hartford, CT, is designed to understand th e environmental and social conditions within "high risk sites" where drug u sers inject drugs or smoke crack, in order to develop AIDS prevention model s that build upon the physical and social organization of these locations. The study assesses high-risk sites characterized on the basis of type of lo cation or structure, presence and strength of gatekeepers, and presence and strength of HIV prevention opportunities and pressures. A combination of e thnographic, epidemiological, and social network methods are used to docume nt the characteristics, social organization, natural history, and dynamics of these sites, the network relations of site users, and the various opport unities for, or barriers to, on-site social-level HIV prevention interventi on. This paper provides an overview of the study and presents preliminary f indings, including the degree to which drug injectors and crack smokers use specific types of sites in Hartford. The paper also discusses the ways the se findings inform development of on-site, type-specific and peer-led or st ructural HIV-prevention interventions.