REFLECTIONS ON 25 YEARS OF HIV AND AIDS RESEARCH AMONG DRUG ABUSERS

Booth: Since early in the HIV epidemic, street outreach workers, often indigenous to the tar-get population, have served both to recruit drug injectors for interventions and to conduct interventions. The typically unstructured nature of outreach interventions present challenges in determining the nature of services actually delivered. It is recommended that both qualitative and quantitative methods be utilized to monitor intervention service delivery. Des Jarlais: The threat of AIDS has led to profound behavioral changes among drug users. These changes need to be seen primarily not as responses to public health interventions, but in terms of the competencies of drug users themselves. A Drug User Competency Model of HIV Prevention would include: 1. Competency in understanding HIV transmission, 2. Competency in reducing HIV risk behavior, and 3. The competency of altruism. Friedman: Twenty years of work on HIV among drug users' highlight that we need to incorporate large-scale social dynamics in research and interventions, understand drug users sexual behavior and networks, and view drug users as multifaceted human beings, not just 'walking addictions.' Crucially, drug users can be highly competent at many things, so non-users can learn from their ideas and their practices. Drug users can be partners and sometimes leaders, not just 'disabled addicts.'