Autonomous Health Movements: Criminalization, De-Medicalization, and Community-Based Direct Action.

This paper proposes the concept of autonomous health movements, drawing on an analysis of harm reduction in the United States and self-managed abortion globally. Harm reduction and self-managed abortion appear in the professional literature largely as evidenced-based public health strategies, more than as social movements. However, each began at the margins of the law as a form of direct action developed by activists anchored in social justice movements and working in community contexts independent of both state and institutional control according to a human rights perspective of bodily integrity and autonomy.

Migration narratives: expanding methods to examine the interaction of person and environment among aging gay men.

As they age, gay and bisexual men are embedded in multiple environments and communities. This article reanalyzes data collected as part of a larger qualitative study of crystal methamphetamine use in New York City. Focusing on the migration narratives of 30 racially/ethnically diverse men, age 40 years old and older, recruited from multiple venues several key areas emerged: ostracization, lack of affirmation as well as movement activities.

Sexual contexts and the process of risk reduction.

Understanding the dynamics of sexual risks for HIV among men who have sex with men has been one of the ongoing challenges of HIV prevention. While the majority of HIV-prevention interventions target individual behaviour and decision making, multiple studies point to the importance of social context in shaping risk behaviour. Analysis of qualitative data from a study of men who have sex with men, drug use and sex found that sexual encounters were made up multiple contextual and interpersonal elements, which interacted to shape sexual practices and risk reduction strategies.

Drug use, community action, and public health: gay men and crystal meth in NYC.

In 2004, GLBT and HIV/AIDS service providers in NYC mobilized against use of crystal methamphetamine among gay men. Both drug use and mobilization were shaped by the history of HIV, particularly the institutions, action repertoires, and social networks forged in earlier AIDS work. This paper is based on qualitative research conducted from 2007 to 2009 with advocates, service providers, and men who have sex with men recruited from diverse venues in NYC gay communities.

Neighborhood History as a Factor Shaping Syringe Distribution Networks Among Drug Users at a U.S. Syringe Exchange.

Throughout the US, high-visibility drug markets are concentrated in neighborhoods with few economic opportunities, while drug buyers/users are widely dispersed. A study of Pittsburgh Syringe Exchange participants provides data on travel between and network linkages across neighborhoods with different levels of drug activity. There are distinct racial patterns to syringe distribution activity within networks and across neighborhoods.

Unstable housing as a factor for increased injection risk behavior at US syringe exchange programs.

Objective: To assess variation in injection risk behavior among unstably housed/homeless injecting drug users (IDUs) across programs in a national sample of US syringe exchange programs.

Methods: About 23 syringe exchange programs were selected through stratified random sampling of moderate to very large US syringe exchange programs operating in 2001-2005. Subjects at each program were randomly sampled.

Residual injection risk behavior, HIV infection, and the evaluation of syringe exchange programs.

This study assessed relationships between residual risk behavior (risk behavior among persons participating in effective HIV prevention programs) and HIV infection. Structured interviews and HIV tests were obtained from participants in six large U.S.

Patterns of sexual commerce among women at US Syringe Exchange Programs.

In the USA, the majority of research on sex work has examined the experiences of women recruited from social locations commonly referred to as the 'sex industry', such as street strolls or escort services. This paper presents data from female syringe exchange participants who had sold sex in the last 30 days. The women interviewed for this study report a much broader array of commercial transactions than found in previous US studies, including selling sex to women, paying men for sex, and considerable role fluidity between buying and selling.

Diffusion of the D.A.R.E and syringe exchange programs.

We examined the diffusion of the D.A.R.

HIV risk behavior among amphetamine injectors at U.S. syringe exchange programs.

The goal of this study was to compare HIV risk behaviors of amphetamine and non-amphetamine injectors at syringe exchange programs (SEP) in the United States and to identify factors associated with injection risk. This analysis is based on data from a random cross-section of participants at 13 SEPs in different parts of the country. All interviews were done using Audio Computer-Assisted Personal Interviewing technology.

Long-term effects of syringe exchange on risk behavior and HIV prevention.

The purpose of this study was to assess stability of population-level injection risk behavior over time among participants in a syringe exchange program and compare factors affecting syringe sharing at two points in time. Participants of the Tacoma Syringe Exchange Program were interviewed in 1997 and 2001 using audio computer assisted self-interviewing technology. In each wave of data collection, a random cross section of participants was recruited and interviewed, with no attempt made to follow respondents over time.

"Informed altruism" and "partner restriction" in the reduction of HIV infection in injecting drug users entering detoxification treatment in New York City, 1990-2001.

Objective: To assess recent developments in the HIV epidemic in injecting drug users (IDUs) in New York City. With >50,000 cases of AIDS in IDUs, New York has experienced the largest HIV/AIDS epidemic in IDUs of any city in the world.

Methods: Serial cross-sectional surveys conducted continuously from 1990 to 2001 of IDUs entering the Beth Israel Medical Center (BIMC) drug detoxification program in New York City.