An economy of risk: resource acquisition strategies of inner city women who use drugs

Researchers suggest that women's HIV risk is influenced by environmental factors. In order to better understand the processes through which environmental factors are mediated into HIV risk, 28 women who used drugs from two low income neighbourhoods in New York City (NYC) participated in life history interviews. Women 18 years or older who used heroin, crack or cocaine were recruited from out-of-treatment settings between March and November 2000. Central to this analysis was an assessment of the strategies adopted for acquiring resources (resource aquisition strategies) as well as the costs and obligations associated with such strategies. The majority of women's resources came from illegal sources or from men with whom they had sexual relationships. Three quarters of the women worked in the drug trade, 68% reported stealing and 68% engaged in street based sex work. Most (89%) women had been arrested. The large majority (79%) had current, male sex partners from whom they received financial and other benefits, including a diminished risk of incarceration. The implicit or explicit trade of sex for a reliable supply of resources severely limited women's ability to implement sex risk reduction. In the context of economic deprivation, most resource acquisition strategies employed by the women increased HIV risk.