Factors Influencing Drug Use and HIV Riskin Two Nicaraguan Cities

摘要

This chapter presents the results of two related exploratory, qualitativestudies on drug use and HIV risk conducted in the cities of Managua and Chinan-dega, Nicaragua between 2002 and 2005. The objectives of this research were to:identify methods of reaching drug using populations in the country; provide an ini-tial description of the patterns of drug use, emphasizing regional differences; explorethe relationship between drug use and HIV transmission; and provide preliminaryrecommendations for the development of drug use and HIV prevention efforts andfor future research directions. The study designs included ethnographic observationand interviews to assist in gaining entry into drug-using communities, in-depth in-terviews with drug users and traffickers (121) and focus groups (13) with sectorsof the population likely to provide different perspectives on the research domains:health professionals working with high-risk behavior groups, female sex workers,gay men, university students, taxi drivers, injection drug users, and family membersof drug users. Drug use, the availability of drugs and distribution were reported,and included: ubiquitous drug supplies; the involvement of all social strata; theimpact of crack on drug-use patterns; concerns about use by children and youth;well-established local distribution mechanisms; group drug purchase and sharing,and (limited) needle use and equipment sharing. Sexual risks included unprotectedsex with partners and sex for drugs and/or drug money. The lack of drug preventioneducation in the community and schools, and limited treatment resources were alsoreported. Conclusions highlight the need for public and policy acknowledgementand response regarding drug use, and the link between HIV/AIDS and drugs in thecountry.