Confronting the AIDS epidemic among i.v. drug users: does ethnic culture matter?

The AIDS education and prevention literature contains numerous calls for the development of culturally relevant efforts to reach members of ethnic minority populations. In the AIDS literature on IV drug users (IVDUs), however, this issue finds less emphasis despite the disproportionate rate of human immunodeficiency virus (HIV) infection in minority IVDUs. The reason appears to be the sense in the drug field that the primary culture of the IVDU is drug culture rather than ethnic culture. This paper explores this issue in light of a review of recent research on IVDUs, ethnicity, and AIDS risk behavior. Specifically, this review covers literature on 6 topics in light of ethnic differences: changing patterns of IV drug use prevalence, AIDS prevalence among IVDUs, needle-related AIDS risk, polydrug use, sexual risk among IVDUs, and the drug subculture. Finding that ethnic culture does matter in infection patterns and risk behavior, this paper examines a typology for the analysis of discontinuities in intercultural communication and presents a framework for comparing alternative models for overcoming cultural barriers to effective AIDS education with IVDUs.