Networking for Drug Injection as a Social Process: a Substantive and Methodological Analysis

INTRODUCTION Substance abuse is regarded as the nation’s number one health problem (Robert Wood Johnson Foundation, 2001), and HIV/AIDS risks are known more prone among drug injectors and disproportionately more concentrated among African American drug injectors (Friedman, Jarlais, and Ward, 1993; CDC, 1996). According to the Center for Disease Control (1998), 217,000 injecting drug users (IDU) had been diagnosed with AIDS as of 1998, and 87,000 had died of the disease. Clearly, drug injection practice must be a major focus of HIV prevention efforts. What has been less clear is whether members of networked IDU groups with different connections among them have similar level of higher risks of HIV/AIDS. Although most injecting drug users do not use alone, it remains largely unknown what kind of network ties would signify, and for what kind of drug behavior. Comparatively little attention has been devoted to quantitatively assessing network structure and its etiological factors driving the formation and maintenance of cohesive subgroups as well as roles and positions within networks. The objective of this study is twofold: first, to examine what and how specific positions and roles held by drug injectors would be conducive to higher HIV/AIDS risk; second, to examine whether there exists potential systematic self-motivated social selection in terms of social networked ties. The research questions of this study are: (1) what personal and behavioral characteristics contribute to the drug injectors’ relational settings in their web of connections? (2) what personal and behavioral characteristics contribute to the drug injectors’ positional settings in their web of connections? and (3) what are the structural network covariates of the IDU’s chance to be infected with HIV?