title: Getting clean and harm reduction: adversarial or complementary issues for injection drug users.
abstract: Many contemporary HIV prevention interventions targeting injection drug users (IDUs) have been implemented using Harm Reduction as a theoretical framework. Among drug-using individuals, however, the abstinence-based "getting clean" models espoused by Narcotics Anonymous and other widely adopted approaches to drug treatment are often more readily accepted. This paper describes an ethnographic examination of the ideological dichotomy between Harm Reduction and abstinence-based "getting clean" treatment model which emerged during the piloting phase of an HIV prevention intervention in Baltimore City, Maryland, USA. This paper describes how the conflict was identified and what changes were made to the intervention to help resolve the participants' dichotomous thinking concerning their substance abuse issues.
authors.affiliation: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. jpeterso@jhsph.edu
authors.forename: James
authors.initials: J
authors.lastname: Peterson
authors.forename: Shannon Gwin
authors.initials: SG
authors.lastname: Mitchell
authors.forename: Yan
authors.initials: Y
authors.lastname: Hong
authors.forename: Michael
authors.initials: M
authors.lastname: Agar
authors.forename: Carl
authors.initials: C
authors.lastname: Latkin
mesh_terms: D000884:Anthropology, Cultural; D015142:Baltimore; D005260:Female; D017144:Focus Groups / Q000379:methods*; D015658:HIV Infections / Q000517:prevention & control*; D040261:Harm Reduction; D006801:Humans; D008297:Male; D010865:Pilot Projects; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000517:prevention & control / Q000534:rehabilitation*