AIDS and its Impact on Drug Research

Between 1975 and 1985 the group of ethnographic researchers on the use of illegal street drugs remained very small, roughly 20 people. In 1987, an initiative to slow the spread of infection by the Human Immunodeficiency Virus (HIV) among injecting drug users (IDUs) sought to establish ethnographic capabilities in interventions throughout the United States. This initiative, funded by NIDA, led to the gainful employment of more than 20 doctoral level anthropologists in cities all over the United States. Each site in the initiative was required to have an ethnographic component, which provided observational data and in-depth interviews with IDUs in order to characterize local patterns of self-injection behavior. This feature attracted already accomplished investigators from other varieties of research, as well as newcomers to drug research. None had studied illegal drug use before, but their inclusion in the effort to prevent HIV infection among IDUs brought fresh perspectives and new capabilities to the mix of anthropologists studying illegal drugs.

Among the senior anthropologists involved in this new endeavor were Robert Trotter and Merrill Singer. Among the newcomers were Stephen Koester, Robert Carlson, and Claire Sterk. All eventually distinguished themselves with significant contributions to the study of street-based drug use. Trotter and colleagues focused on networks of informal social relations among IDUs

(cf. Trotter, Bowen, & Potter, 1995). Singer wove his studies of IDUs in Hartford into his well-known critical perspective (Baer, Singer, & Johnson, 1986; Singer, Baer, & Susser, 1999) in medical anthropology. Koester (1994), taking a cue from observational studies by Page (Page, 1990; Page, Chitwood, Smith, Kane, & McBride, 1990; Page, Smith, & Kane, 1990) used direct observation to explain the aversion of IDUs to carrying their own syringes. Carlson (Carlson, Wang, Siegal, Falck, & Guo, 1994) elaborated a sampling scheme for studying communities with drug-related HIV contagion. He also provided a fully contextualized perspective on injecting drug use in the United States (Carlson, 1996). Sterk (1999) thoroughly characterized the status of women who become involved in intensive drug use and the sex trade.

The most intensive study of street drug use by anthropologists has taken place in the United States, but ethnographers in Europe have also conducted important studies. Gamella (1990, 1994) analyzed the lives of IDUs in Madrid, tracing the trajectory of a new heroin epidemic and its concomitant spread of HIV infection. He also produced the definitive work on methylenedioxy-n-methylamphetamine (MDMA) and its use among youth in Spanish nightclubs (Gamella, 1999). Also in Spain, Page and Salazar (1999a, 1999b, 2001) have offered ethnographic evidence that the mere availability of needles and syringes may not suffice to slow the spread of HIV.

Other North American contributions to the anthropological literature on drug use have included Bourgois' In Search of Respect (1995), which used a contemporary critical perspective to humanize crack users in East Harlem, and Waterston's Street Addicts in the Political Economy (1993), which placed Philadelphia's IDU population in a political and economic context. These works drew upon the growing richness of ethnographic literature on drug use.

Pregnancy And Childbirth

Pregnancy And Childbirth

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