The Social Construction of Sexual Relationships as a Determinant of HIV Risk Perception and Condom Use among Injection Drug Users

Abstract

Injection drug users (IDUs) occupy an important position in the HIV pandemic, not only because of their high risk of contracting the virus through sharing injection equipment and unsafe sex, but also because of their potential to transmit the virus to their non‐injecting heterosexual partners and to infants. To date, only modest gains in safer sex practices have been reported among IDUs, in spite of their almost universal knowledge of the modes of sexual and vertical transmission and widespread generalized and targeted risk reduction education programs. This article explores the basis for low levels of condom use and the apparent cognitive barriers to perceiving personal risk of sexual transmission of HIV in this population. Analysis of the social meaning of risk behavior and of sexually transmitted disease points to the importance of the social construction of sexual relationships as a determinant of personal HIV risk perception and condom use.