RESUMEN
This exploratory study utilized a focus group methodology to explore tensions and barriers in HIV/AIDS prevention among African-American injection drug users. Participants discussed HIV infection risks, national/community HIV prevention effectiveness, prevention barriers, ideas on barrier removal, and the tensions which exist between users and the larger African-American community. Recognizing the inevitability of continued drug use for many injectors, participants requested basic harm-reduction supplies including condoms, needle exchange programs, additional drug user treatment services, and the use of culturally- and gender-matched peer-led prevention and treatment outreach. Preliminary recommendations are made for consideration in HIV/AIDS prevention among African-American IDUs.
Asunto(s)
Negro o Afroamericano/psicología , Barreras de Comunicación , Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Abuso de Sustancias por Vía Intravenosa/prevención & control , Abuso de Sustancias por Vía Intravenosa/psicología , Adulto , Actitud , Condones , Toma de Decisiones , Femenino , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Programas de Intercambio de Agujas , Asunción de Riesgos , Centros de Tratamiento de Abuso de SustanciasRESUMEN
This article proposes a systemic reform of the organizational structure and delivery of substance abuse services for adolescents within the juvenile justice system. It first discusses the impact of substance use on the juvenile justice system and then reviews which drug treatment programs and services are currently available. Following an evaluation of the most effective drug treatment programs and modalities, recommendations for system reform are given. The recommendations are based on a graduated sanctions framework, supported by systems collaboration and comprehensive case management. Systems collaboration between service providers must exist for juveniles to receive appropriate and comprehensive services. Case managers (CMs) both assess juveniles and help them move through and between judicial, drug treatment, and social service systems. In this way, juveniles receive the most suitable and complete services a community can offer while remaining firmly under juvenile justice system supervision.