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It is incredibly easy to make terrible mistakes. Rather, research regarding HIV and sexual behavior among female drug users is dominated by a risk-focused epidemiological paradigm which narrowly defines risk behaviors, measures their prevalence and explores the correlates of these behaviors e. Vital knowledge has been gained about drug-using women and sexual risk behavior such as unprotected sex and multiple male partners using epidemiological methods S. However, the focus on violence, trauma and social disadvantage often predominates to the degree that it obscures any sense of agency or pleasure women who use drugs may experience.
Nevertheless, the common-sense notion of agency as a measure of individual empowerment and efficacy is valued by drug users and can be a powerful component of successful drug treatment P. The pursuit of pleasure is one arena in which feelings of agency may play out. One explanation for this absence is the emphasis on pathological theories of drug use in the U. Similarly, drug-related needs — not pleasure or desire — are seen as the primary motivation for sexual engagement. In this framework, it is difficult to make room to document the potentially positive aspects of sexual behavior and drug use.
In addition, the widespread criminalization and social condemnation of drug use contributes to a research environment that rewards scientists for focusing on disease and risk, and provides little incentive to delve into areas like pleasure that appear vaguely disreputable, not to mention difficult to quantify and analyze Duff, The marginalization of desire and pleasure in HIV research may imperil our ability to develop effective prevention strategies. To date, interventions to reduce sexual risk behavior among drug users, tested in randomized controlled trials, have been moderately successful at best.
The lackluster showing of sexual risk behavior interventions suggests that we may be missing key information about sexual behavior among drug users, and that intensive efforts to date may not be pursuing a productive direction. An enhanced evidence base — one which incorporates the perceived rewards and benefits of sexual behavior in the context of drug use — may be needed to develop more effective sexual risk reduction strategies. This paper explores the relationship between sexual behavior and methamphetamine use in a community-based sample of women who use drugs in San Francisco, CA. Using mixed methods, it delves into different dimensions of sexual behavior and methamphetamine use — inclusive not only of the risk of unprotected intercourse, but of desire, pleasure and the challenges of overcoming trauma.
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Our goal was to understand sexual behavior as an experience rather than solely as a risk behavior. By extending the boundaries of conventional HIV risk assessment; this research strives to bring new depth and uorney Junior horney old women nude understanding ood sexual honey of women who use drugs. Rather, the two methodological approaches provide different perspectives on similar, but often not identical, issues. Interpreting data using mixed methods requires active engagement in both views Ciccarone,much like looking through the dual lenses of a pair of binoculars.
The study described here was designed to use mixed methods from its inception. Based on the knowledge that sexual behavior among disadvantaged women is complex and multi-dimensional, the intention was to complement quantitative findings with qualitative data regarding the contexts and circumstances of unprotected sex.