title: Symbiotic goals and the prevention of blood-borne viruses among injection drug users.
abstract: A positive-deviance control-case life history study of injection drug users (IDUs) in New York City who had injected drugs for 8-15 years compared 21 IDUs who were antibody negative for both HIV and hepatitis C with 3 infected with both viruses and 11 infected with hepatitis C virus but not HIV. Eligible subjects were referred from other research studies and from community organizations that conduct testing for HIV and hepatitis C virus. Data were collected during 2005-2008 and were analyzed using life history and grounded theory approaches. They support grounded hypotheses that IDUs who are able to attain symbiotic goals like avoiding withdrawal and maintaining social support are assisted thereby in remaining uninfected with HIV or hepatitis C. These hypotheses should be tested using cohort studies and prevention trials to see if helping IDUs attain symbiotic goals reduces infection risk. The study's limitations are noted.
authors.affiliation: Center for Drug Use & HIV Research, National Development and Research Institutes, Inc., New York, New York 10010, USA. friedman@ndri.org
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Friedman
authors.forename: Milagros
authors.initials: M
authors.lastname: Sandoval
authors.forename: Pedro
authors.initials: P
authors.lastname: Mateu-Gelabert
authors.forename: Peter
authors.initials: P
authors.lastname: Meylakhs
authors.forename: Don C
authors.initials: DC
authors.lastname: Des Jarlais
mesh_terms: D016022:Case-Control Studies; D055030:Drug Users; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006526:Hepatitis C / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D008297:Male; D016485:Needle Sharing; D009519:New York City; D012309:Risk-Taking; D012944:Social Support; D015819:Substance Abuse, Intravenous