Yale University

Injection Drug Use within the Family Context: Damage Limitation, Qualification, and Acceptance

Principle Investigator(s):

Funder: CIRA
Project period: 02/01/2012 - 01/31/2013
Grant Type: Pilot Project

Abstract Text:

HIV prevalence among injection drug users (IDUs) is highest of any behavioral risk group in Connecticut.  During the past 30 years, nearly 20,000 HIV cases and over 9,000 deaths have been reported.  Yet the use of HIV, substance abuse (SA), and harm reduction (HR) services is less than would be the expected service needs of this population.

Our on-going research suggests that family dynamics and interactions pose an important yet largely overlooked barrier to service utilization.  Approximately 55% of participants currently live with another family member, and many continue to have frequent contact with their parents and siblings.  These family members potentially can play an important role in helping them to enter into – and adhere to – these services.
The proposed project will tell us how non-drug using family members can hinder or promote utilization of HIV, SA, and HR services for IDU family members.  This is a largely unexplored area as most family-based HIV prevention studies have focused on the non-drug-using children.

  1. A total of 56 open-ended, qualitative interviews will be conducted.  The specific aims are;
  2. to understand from the IDU perspective how family dynamics and interactions may influence IDUs’ willingness to use and adhere to HIV, SA, and HR services; we will interview 32 IDUs.
    to understand from non-drug-using family members’ perspectives how family dynamics and interactions may influence IDUs’ utilization of and adherence to HIV, SA, and HR services; we will interview 24 family members, each yoked to an IDU participant;
  3. to integrate the first two aims’ findings, identify core themes that hinder or promote utilization of services, and extend existing theory concerning intra-familial HIV and SA communications beyond that of the parent-child dyad.  We will build hypotheses for a larger R34 intervention development grant application to develop family-based interventions aimed at improving utilization of and adherence to services.