Labor force participation in a sample of substance users.

This paper reviews the microeconomic theory underlying the work/leisure tradeoff and how this tradeoff may be manifested among substance users. The effects of drug use, demographic factors, and income factors on the probability of labor force participation are analyzed in a sample of 687 male and 327 female drug users. The decision not to seek employment appears to be associated primarily with non-job-related sources of income (including illegal sources).

Economics as a factor in models of behavioral motivation and change.

This note first presents a summary of four main behavioral models that are used to explain behavioral motivation and change. Three models are based on psychosocial theory. They are: 1) the Theory of Reasoned Action, 2) the Theory of Planned Behavior, and 3) the Theory of Stages-of-Change. The fourth model is based on economic theory and is known as the Rational Addiction Model. Each model is analyzed for its strengths and weaknesses. The note concludes by arguing for the usefulness of integrating the economic and the psychosocial models to study drug use. Specific examples and suggestions are presented.

Access to HIV services by the urban poor.

This paper examines the effect of HIV-health status and HIV-transmission mode on access to HIV-related services among African Americans, Hispanics and White HIV+ individuals. Data were collected from 169 African Americans, 72 Hispanics and 253 White HIV+ individuals seeking 8 social and 6 medical HIV services at 29 public and community-based organizations in Houston, Texas. A total of 42 separate logistic regressions were estimated for each HIV service and for each race/ethnic group. The results showed significant differences in access to HIV social services based on HIV-transmission mode among the three race/ethnic groups, but no significant differences were found in access to medical services based on either HIV status or HIV-transmission mode among the three race/ethnic groups.

Estimated HIV risk among Hispanics in a national sample of drug users.

OBJECTIVE: To estimate and compare the HIV risks among three Hispanic subpopulations. METHODS: Chronic drug users participating in a nationwide intervention study on drug use were interviewed with regard to drug use and sexual behavior. HIV risk was estimated using information about individuals' HIV-relevant behaviors, the social context (i.e., city) in which such behaviors occur, and published estimates of HIV transmission for various risk behaviors. Multiple linear regression analysis was used to investigate differences in estimated HIV risk between Puerto Rican, Mexican-American, and Mexican drug users, accounting for sociodemographic factors, sexual preference, and geographic region. RESULTS: Puerto Ricans had significantly greater estimated overall HIV risk, estimated injection risk, and in general, significantly greater estimated sexual risk than Mexican Americans and Mexicans. No significant differences were found in any estimated risk between Mexican Americans and Mexicans in this sample. No significant differences were found among any of the subgroups for estimated risk from having anal sex while using a condom, or from having receptive anal sex without using a condom. CONCLUSIONS: These findings suggest that Puerto Ricans who use drugs experience a higher risk of HIV infection than other Hispanic drug users. Research is needed to identify which economic, social, and cultural components account for this increased risk.

Modeling HIV risk.

OBJECTIVE: To provide HIV risk estimates for specific local population subgroups using an HIV risk index combining HIV risk behaviors, prevalence rates, and transmission probabilities. METHODS: A sample of 270 individuals was studied. Respondents described sexual and injection risk behaviors and partners in the previous 30 days. An HIV risk index was computed for each individual, combining reported sexual and injecting risk behaviors, HIV prevalence estimates for partners and HIV transmission probabilities for each of the risk behaviors. Partner HIV prevalence rates were estimated from a national sample, and HIV transmission probabilities were obtained from previously published studies. RESULTS: Projected risk estimates were found to differ a great deal within major demographic categories. Highest 10-year risk was found among African-American male gay injectors (72%) and the lowest among white male heterosexual noninjectors (<.01%). CONCLUSIONS: The method used here for estimating HIV risk can be calculated for specific at-risk population subgroups of any size and composition, including individuals. By understanding which specific subpopulations are at risk, specific interventions and public health campaigns may be better targeted.

The impact of public health media campaigns on drug users.

Evaluation of public health media campaigns to influence change in high-risk behavior often bemoans a lack of relevance to the target audiences as well as an absence of integrated interpersonal and mass-mediated communication channels. The assumption that illegal drug users are disconnected from mass-mediated communication may account for this absence of media interventions. However, the authors' HIV-prevention research project demonstrates that many out-of-treatment drug users are media consumers. Furthermore, it shows that participants who recalled seeing or hearing media interventions report greater levels of positive behavior change than participants who do not recall such messages. Results suggest strong coordination of human services messages that are relevant to out-of-treatment drug users to facilitate changes in behavior.