title: Sex, drugs, and the spread of HIV/AIDS in Belle Glade, Florida.
abstract: Belle Glade, Florida, an agricultural community in the heart of the state's vegetable and sugar cane production areas, has the highest cumulative per capita incidence of AIDS in the United States. A risk reduction intervention program was introduced to lessen unsafe AIDS-related behaviors and to generate data on the epidemiology of HIV infection. Initial attention focused on individuals who were believed to be at the core of the transmission pattern, injection drug users and their sexual partners. We found, however, that injection drug use was much less widespread than anticipated. Results suggested that the primary mode of HIV transmission is heterosexual intercourse-mediated by drug taking (particularly crack smoking) and a flourishing sex industry-a finding that is corroborated by the increased and disproportionate rate of heterosexual AIDS in Belle Glade. The prevalence and types of risk behaviors engaged in would not have been completely explained without the use of ethnographic methods including observation of, and lengthy interviews with, the populations at risk.
authors.affiliation: Department of Epidemiology and Public Health, University of Miami, USA.
authors.forename: C B
authors.initials: CB
authors.lastname: Mccoy
authors.forename: L R
authors.initials: LR
authors.lastname: Metsch
authors.forename: J A
authors.initials: JA
authors.lastname: Inciardi
authors.forename: R S
authors.initials: RS
authors.lastname: Anwyl
authors.forename: J
authors.initials: J
authors.lastname: Wingerd
authors.forename: K
authors.initials: K
authors.lastname: Bletzer
mesh_terms: D000328:Adult; D000383:Agriculture; D016578:Crack Cocaine; D005260:Female; D005431:Florida / Q000453:epidemiology; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology / Q000635:transmission*; D015528:HIV Seroprevalence / Q000639:trends; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D011477:Sex Work / Q000706:statistics & numerical data; D012725:Sexual Behavior; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000534:rehabilitation; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation
chemical_list: D016578:Crack Cocaine