Crack Use Sites and HIV Risk in El Salvador

By Dickson-Gomez, Julia; Bodnar, Gloria et al. | Journal of Drug Issues, Spring 2007 | Go to article overview

Crack Use Sites and HIV Risk in El Salvador


Dickson-Gomez, Julia, Bodnar, Gloria, Guevara, Aradenia, Rodriguez, Karla, Gaborit, Mauricio, Journal of Drug Issues


"The Social Context of Crack Use and Related Sexual Risk in El Salvador" study was designed to increase knowledge of the locations where drugs are consumed in urban San Salvador, the social dynamics within such sites, and their implications for HIV risk and prevention efforts. In-depth interviews with crack smokers reveal several different types of sites where drugs are consumed and risky sex may occur including trances (generally houses where crack is sold and consumed), brothels, motels, drug users' own homes, abandoned buildings, the street, parks, or cantinas. These range from private sites, where site "gatekeepers" strictly control access, to public sites where access is more open. However, even in more public sites there is considerable social interaction, rules regarding site usage, and in some cases gatekeeper control of the site. Social dynamics already normative at drug use sites may support a site-based, peer-led intervention approach.

INTRODUCTION

According to a report by USAID's Bureau of Global Health, the prevalence of HIV in El Salvador is 0.7%, although they estimate the prevalence for vulnerable populations such as commercial sex workers and street children to be considerably higher at 10% and 20%, respectively (USAID Bureau of Global Health, 2004). The primary exposure category is through heterosexual transmission (78.8%), followed by men who have sex with men (13.6%), with injection drug use comprising only 0.9% of the cases (UNAIDS/World Health Organization [WHO], 2002). Along with the increase in HIV infection, the local market for cocaine has greatly expanded in the last decade and crack cocaine is a growing problem in San Salvador's greater metropolitan area in marginal and working class communities (Dickson-Gomez, 2004; Santacruz Giralt, & Concha-Eastman, 2001; United Nations Development Program, 2004). A national survey conducted in 2004 found that 1% of the population aged 12 to 45 living in San Salvador consumed crack in the last month, while a study of nearly 1,000 gang members found that 65.7% had consumed crack in the last month, and 25.8% consumed crack daily (Santacruz Giralt & Concha-Eastman, 2001).

HIV researchers have increasingly called attention to the need to understand the social context in which risky sex and drug use takes place in order to plan more effective HIV prevention interventions (Carlson, 2000; Koester, 1995; Weeks et al., 2001). There is now a considerable body of qualitative and ethnographic research in the United States and other developed countries on the locations where risky sex and drug use takes place, the social dynamics, rules and norms present in these high risk sites (Chitwood et al., 1990; Inciardi, 1993, 1995; Latkin et al., 1994; Page & Llanusa-Cestero, 2006; Page & Salazar Fraile, 2001; Page, Smith, & Kane, 1991; Waiters & Guydish, 1994; Weeks et al., 2001). However, very little research has examined the social context of risky sex and drug use in developing countries.

THE SOCIAL CONTEXT OF CRACK USE

In the United States, crack use has been associated with a number of sexual behaviors that may contribute to the spread of HIV and AIDS (Inciardi, 1993; Ratner, 1993; Ross, Hwang, Leonard, Teng, & Duncan, 1999; Ross, Hwang, Zack, Bull, & Williams, 2002). Many researchers have argued that crack use has contributed to changes in the conditions in which street sex work takes place, including lowering prices for sexual services (Maher, 1997; Miller, 1995), more sex partners (Inciardi, 1989), higher risk sexual practices (Ratner, 1993), and increases in direct "sex for crack" exchanges (Bourgois & Dunlap, 1993; Boyle & Anglin, 1993; Inciardi, 1993; Koester & Schwartz, 1993; Ouellet, Wiebel, Jiminez, & Johnson, 1993; Ratner, 1993). Sex for crack exchanges are reported to be particularly prevalent in crack houses, where the drug is either bought, consumed or both, and often involve extreme degradation of women who can exercise less control than in sex for money exchanges (Bourgois & Dunlap, 1993; Miller, 1995). …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • A full archive of books and articles related to this one
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Crack Use Sites and HIV Risk in El Salvador
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

    Already a member? Log in now.