title: Double jeopardy through social marginalization: HIV risk among Tajik male labor migrants in Moscow.
abstract: BACKGROUND
  This study examines the influence of the double jeopardy of being both a migrant and an injection drug user on the social marginalization of male Tajik labor-migrants working in Moscow and the influence of this dual-marginalization on HIV risk.
  
  
  METHODS
  Three focus group discussions of 8 participants each were conducted in Moscow with a total of 24 Tajik male migrants who regularly inject drugs (IDUs).
  
  
  RESULTS
  Results suggest that male Tajik IDUs are at double jeopardy for social marginalization from both Russian society and their own Tajik migrant community. In the absence of adequate knowledge about HIV risk through needle-borne infection, such dual social rejection can help to push Tajik migrant IDUs toward forging close social alliances with their drug-using peers based on a sense of community through sharing drugs and injection equipment. Sexual contact with Russian female sex workers, many of whom use drugs, further contributes to HIV vulnerability and forms a potential bridge for the cross-over of the virus between both populations. With little to no access to formal health services, family and friends living in Moscow can form a sole source of social support at a personal level that can over-ride general community censure but which can lessen or disappear as drug dependency increases.
  
  
  CONCLUSIONS
  Both drug and health services are sorely needed for this highly vulnerable population.
authors.affiliation: PRISMA Research Center, Dushanbe 734029, Tajikistan. Electronic address: mahbat@rambler.ru.
authors.forename: Makhbatsho
authors.initials: M
authors.lastname: Bakhromov
authors.forename: Judith A
authors.initials: JA
authors.lastname: Levy
mesh_terms: D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D017144:Focus Groups; D015658:HIV Infections / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009031:Moscow / Q000453:epidemiology; D012306:Risk; D062487:Social Marginalization; D012944:Social Support; D015819:Substance Abuse, Intravenous / Q000208:ethnology*; D013620:Tajikistan / Q000208:ethnology; D014171:Transients and Migrants
keywords: Drug use; HIV risk; Labor migration; Marginalization