Claire E. Sterk

Integrating the general theory of crime into an explanation of violent victimization among female offenders

In 1999, Schreck extended Gottfredson and Hirschis (1990) self-control theory to explain victimization and the victim-offender overlap. His analysis of college students revealed that low self-control was significantly associated with victimization. We build on Shrecks work by assessing whether low self-control contributes to victimization among a sample of female offenders while controlling for routine activities/lifestyle behaviors. We advanced two research questions: (1) Can self-control theory account for variations in victimization? (2) Do risky lifestyle behaviors mediate the effects of self-control? The results were consistent with the hypothesis that low self-control is a risk factor for victimization, even after lifestyle behaviors were controlled.

Crack, sex, and STD

Increasing rates of syphilis, gonorrhea, chancroid, and sexually transmitted human immunodeficiency virus infection appear to be related to crack cocaine use. This article critically reviews 16 epidemiologic studies that examine drug use, sexual behavior, and sexually transmitted disease (STD). Eight studies found an association between crack and STD, one study found no association between crack and STD, and seven studies found STD to be related to other drugs or methods of cocaine use. The exchange of sex for money or drugs was associated with STD in seven studies. Publications that were reviewed have numerous methodologic weaknesses: broader sampling, uninfected comparison groups, and greater specification of drug use and sexual risk behaviors are needed. Further research should compare different drugs and associated sexual behavior and STD to assess the unique risk conferred by crack. Designing effective interventions will require investigation of risk behavior determinants and barriers to health care.

The Limits of Social Capital: Durkheim, Suicide, and Social Cohesion

Recent applications of social capital theories to population health often draw on classic sociological theories for validation of the protective features of social cohesion and social integration. Durkheims work on suicide has been cited as evidence that modern life disrupts social cohesion and results in a greater risk of morbidity and mortality-including self-destructive behaviors and suicide. We argue that a close reading of Durkheims evidence supports the opposite conclusion and that the incidence of self-destructive behaviors such as suicide is often greatest among those with high levels of social integration. A reexamination of Durkheims data on female suicide and suicide in the military suggests that we should be skeptical about recent studies connecting improved population health to social capital.

HIV Risk Reduction Among African-American Women Who Inject Drugs: A Randomized Controlled Trial

A community-based HIV intervention for African-American women who are active injection drug users (IDUs) was evaluated. Seventy-one women (aged 20–54 years) were randomly assigned to one of two enhanced gender- and culturally specific intervention conditions or to the NIDA standard condition. Substantial decreases (p < .001) were found in the frequency of drug use and the frequency of drug injection as well as in the sharing of injection works or water and the number of injections. Trading sex for drugs or money, having sex while high, as well as other sexual risk behaviors were also reduced significantly. Furthermore, women in both enhanced intervention conditions were more likely to reduce their drug-using and sexual risk behaviors than were women in the standard condition. Results indicate the value of including additional components in interventions designed to reduce the risk of infection with HIV among women who inject drugs.

The Atlanta Urban Networks Study: a blueprint for endemic transmission

ObjectiveTo study prospectively social networks and behavior in a group of persons at risk for HIV because of their drug-using and sexual practices, with particular emphasis on the interaction of risks and concomitant network structure. MethodsA longitudinal study was conducted of 228 respondents in Atlanta, Georgia in six inner-city community chains of connected persons, interviewing primary respondents and a sample of their contacts every 6 months for 2 years. Ascertained were: HIV and immunologic status; demographic, medical, and behavioral factors; and the composition of the social, sexual, and drug-using networks. ResultsThe prevalence of HIV in this group was 13.3% and the incidence density was 1.8% per year. Substantial simultaneity of risk-taking was observed, with a high level of both non-injecting (crack, 82%) and injecting (heroin, cocaine or both, 16–30%) drug use, the exchange of sex or money for drugs by men (approximately 35%) and women (57–71%), and high frequency of same-sex sexual activity by men (9.4%) and women (33%). The intensity of interaction, as measured by network features such as microstructures and concurrency, was significantly greater than that observed in a low prevalence area with little endemic transmission. ConclusionThe traditional hierarchical classification of risk for HIV may impede our understanding of transmission dynamics, which, in the setting of an inner-city population, is characterized by simultaneity of risk-taking, and moderately intense network interactions. The study provides further evidence for the relationship of network structure to transmission dynamics, but highlights the difficulties of using network information for prediction of individual seroconversion.

Rolling Beyond Raves: Ecstasy Use Outside the Rave Setting

In this paper, we explore settings of ecstasy use other than those that are part of the rave scene. Little is known about its use in other settings. Data from young adult (18–25 years old) active ecstasy users were collected using surveys (N = 158) and qualitative in-depth interviews (N = 66). Recruitment involved targeted and theoretical sampling. Data analysis was guided by the constant comparison method, common in grounded theory. Our findings indicate that ecstasy use has extended to social settings beyond raves, including dance/music venues, bars in inner-city neighborhoods, neighborhood cruising sites, and private residences. Users may attend multiple settings, and it is common for use practices to be transmitted across settings. An understanding of emerging social settings of ecstasy use and the associated use patterns provides baseline information for the development of effective and appropriate prevention and intervention programs, including drug treatment, as well as for policy makers.

Functional methamphetamine use: The insider's perspective

Methamphetamine use and its social and health consequences pose a serious public health challenge in the United States and beyond. The focus of this article is on functional methamphetamine use from the insiders perspective. In-depth interviews were conducted in Atlanta, Georgia with 40 heavy methamphetamine users. Heavy use was defined as having used methamphetamine at least 10 times during the 30 days prior to the interview. For these respondents, functional use comprised using methamphetamine to improve an action or skill. Further exploration resulted in three recurrent categories of functional use. These include enhanced functioning, increased productivity, and the ability to function normally while using methamphetamine. It is argued that functional drug use may not be unique to methamphetamine. In addition, the findings show the importance of incorporating the complexities of functional use in future studies as well as risk reduction and treatment services targeting drug users.

Safe Living: The Impact of Unstable Housing Conditions on HIV Risk Reduction Among Female Drug Users

The objectives of this article are to explore differences in HIV risk behaviors and subsequent risk reduction among female drug users based on their housing conditions. In addition, we investigate psychosocial characteristics as mediators. Data were collected from 336 adult women. Structured interviews were conducted at baseline and at 6-month follow-up. At baseline, women with unstable housing conditions reported higher levels of HIV drug and sex-related HIV risk behavior. In addition, their levels of behavioral change over time were lower. The findings also show the importance of expanding the stable housing condition into two categories thereby distinguishing between a woman’s own and someone else’s place. None of the mediating factors were statistically significant and there was no moderation by intervention condition. The findings suggest that unstable housing conditions form a structural barrier to HIV risk reduction irrespective of the message. Future interventions should consider such conditions and the larger social context of the women’s lives.

Self-Esteem and “At Risk” Women: Determinants and Relevance to Sexual and HIV-Related Risk Behaviors

ABSTRACT In this study, we describe the relationship between self-esteem and HIV-related risk behaviors, and explore what factors predict self-esteem levels of “at risk” women. Interviews were conducted with 250 (predominantly African American) women living in the Atlanta, Georgia metropolitan area between August 1997 and August 2000. A community identification process was used to identify potential study participants, with further expansion of the sample via targeted and theoretical sampling and ethnographic mapping procedures. Self-esteem was related to the number of times having oral sex, the number of times having sex with paying partners, the frequency of sexual risk-taking (all during the 90 days prior to interview), the number of different HIV risk behaviors practiced during the previous year, and condom use attitudes and self-efficacy. Greater involvement HIV risk behaviors was associated with lower self-esteem. Multivariate analyses revealed five significant predictors of womens self-esteem levels: race, religiosity, childhood experiences with emotional neglect, the number of money-related problems experienced, and the number of drug-related problems experienced. The findings indicate that self-esteem is highly relevant to “at risk” womens HIV risk behavior practices, and this has important implications for HIV intervention programs.

Risks Associated with Tattooing and Body Piercing

The purpose of this article is to highlight the importance of including cosmetic body-piercing and tattooing in HIV prevention and education. Little information about risks associated with tattoos or having ones body pierced is evident in the health promotion and disease prevention literature, particularly among adolescents, ethnic groups, and incarcerated populations. It is incumbent that preventionists address behaviors such as tattooing and body piercing as possible vectors for HIV transmission in addition to typical concerns (homosexuality, IV drug use, condom use and safer sex practices). This article draws attention to the need for formation of regulatory policy issues related to body piercing and tattooing parlors. Currently, 26 percent of the states have regulatory authority over tattooing establishments, while only 4 states exercise such authority over body-piercing establishments. Implications for future research and policy initiatives are identified.