"What We Want to Know About HIV/AIDS:" An Analysis of Questions Asked by Substance Abuse Clients Attending AIDS Education Classes in Puerto Rico

Abstract

An analysis of the questions about human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) asked by intravenous drug users attending AIDS education classes at a public detoxification center in San Juan Puerto Rico provided guidelines for the design of future educational programs. Of the 13007 AIDS cases reported in Puerto Rico by April 1994 an estimated 57% were associated with contact with contaminated drug injecting equipment. The clinics mandatory AIDS education program is comprised of three loosely structured one-hour sessions in which active participation is encouraged. The present study analyzed 372 AIDS-related questions raised by 230 clients in the 50 one-hour sessions that occurred in June-October 1992. 62% of clients reported previous exposure to at least one AIDS education presentation. The questions fell into the following topic areas: HIV transmission and prevention 55.2%; natural history of HIV infection 24.5%; HIV testing 10.5%; treatment 7.0%; and other (e.g. epidemiology legal issues) 3.0%. Common were questions about modes of HIV transmission that while biologically plausible are highly unlikely (e.g. tears sweat saliva or urine). Also raised were questions about the likelihood of virus elimination during the process of heating drugs in a cooker and the use of bleach and alcohol for cleaning injection equipment. There was interest in why exposed individuals vary in their susceptibility to HIV as well as in the effect of illegal drug use on HIV progression. Clients pressured the educators to assign numerical ratings to different types of high-risk activities reflecting their need to pinpoint what constitutes an acceptable risk. As a result of this analysis AIDS educators at the center are now providing demonstrations with injecting equipment that illustrate the potential risk at different moments in the injecting process as well as procedures that eliminate or reduce this risk.