The Transformation of Drug Markets and Its Impact on HIV Outreach to Injection Drug Users in New York City, 1987–2008

Abstract

This oral history describes three periods of street outreach to injection drug users at risk for HIV in New York City: outreach in an era of public drug markets (1987-1993), outreach in an era of private markets (1993-2006), and network-driven outreach (2006-present). Individual interviews with administrators and supervisors of outreach workers are combined with field notes from the ethnographic research experiences of the first two authors to contextualize, compare, and contrast these distinct periods. The combination and triangulation of these sources of data allow for an analysis of both the specific and the wider social and cultural contexts in which outreach intervention efforts were situated. Through these lenses, the article examines some of the reasons why they were or were not successful and discusses prospects for the future.

Network Firewall Dynamics and the Subsaturation Stabilization of HIV

“…These and other forms of enforced propinquity were encouraged by significant changes in drug enforcement regimes in New York at the time. During the 1991–93 time frame, New York City as a whole—and Bushwick in particular, where much of the SFHR study was conducted—was undergoing a change in drug interdiction regimes aimed at closing down “open air” drug markets and injection locations [42–45]. This strategy involved broad “sweeps” in which outdoor users were routinely arrested for small amounts of drug possession.…”

Current and Emerging Research Needs in Studying the NYC HIV–Drug Use Epidemic

“…As seen in many of the articles in this Special Issue, drug users with HIV or at high risk of HIV experience a range of health and social disparities (Freudenberg, 2011; Furst, Curtis, & Balletto, 2011; Heller & Paone, 2011; Strauss & Mino, 2011). Many of these individuals are minority, low income, and poorly educated, with high rates of incarceration and comorbidities.…”