Toward Community Empowerment: The Puerto Rican Ganchero.

IF 2.3 Q3 SUBSTANCE ABUSE
Contemporary Drug Problems Pub Date : 2021-03-01 Epub Date: 2020-10-07 DOI:10.1177/0091450920964576
C Gelpí-Acosta, H Guarino, E Benoit, S Deren, A Rodríguez
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引用次数: 6

Abstract

People who inject drugs (PWID) who migrate from Puerto Rico (PR) to New York City (NYC) are at elevated risk for hepatitis C (HCV), HIV and drug overdose. There is an urgent need to identify a sustainable path toward improving the health outcomes of this population. Peer-driven HIV/HCV prevention interventions for PWID are effective in reducing risk behaviors. Additionally, the concept of intravention-naturally occurring disease prevention activities among PWID (Friedman, 2004)-is a suitable theoretical framework to cast and bolster PWID-indigenous risk reduction norms and practices to achieve positive health outcomes. From 2017-2019, we conducted an ethnographic study in the Bronx, NYC to identify the injection risks of migrant Puerto Rican PWID, institutional barriers to risk reduction and solutions to these barriers. Study components included a longitudinal ethnography with 40 migrant PWID (e.g., baseline and exit interviews and monthly face-to-face follow-ups for 12 months), two institutional ethnographies (IEs) with 10 migrants and six service providers, and three focus groups (FGs) with another 15 migrant PWID. Data were analyzed using a grounded theory approach. In this article, we present findings from the IEs and FGs, specifically regarding a promising intravention pathway to promote health empowerment among these migrants that leverages an existing social role within their networks: the PR-indigenous ganchero. A ganchero is a vein-finding expert who is paid with drugs or cash for providing injection services. Ethnographic evidence from this study suggests that gancheros can occupy harm reduction leadership roles among migrant Puerto Rican PWID, adapting standard overdose and HIV/HCV prevention education to the specific experiences of their community. We conclude by noting the culturally appropriate risk reduction service delivery improvements needed to mitigate the health vulnerabilities of migrants and provide a roadmap for improving service delivery and identifying future research avenues.

迈向社区赋权:波多黎各的甘切罗。
从波多黎各(PR)移民到纽约市(NYC)的注射吸毒者(PWID)感染丙型肝炎(HCV)、艾滋病毒(HIV)和药物过量的风险较高。迫切需要确定一条可持续的途径来改善这一人群的健康状况。同伴驱动的艾滋病毒/丙型肝炎预防干预措施在减少危险行为方面是有效的。此外,静脉干预的概念-在PWID中自然发生的疾病预防活动(Friedman, 2004)-是一个合适的理论框架,可以塑造和支持PWID土著减少风险的规范和实践,以实现积极的健康结果。从2017年到2019年,我们在纽约市布朗克斯进行了一项人种学研究,以确定波多黎各移民PWID的注射风险,降低风险的制度障碍以及这些障碍的解决方案。研究组成部分包括对40名移民PWID的纵向民族志(例如,基线和退出访谈以及为期12个月的每月面对面随访),对10名移民和6名服务提供者的两项机构民族志(IEs),以及对另外15名移民PWID的三个焦点小组(fg)。数据分析采用扎根理论的方法。在本文中,我们介绍了来自ie和FGs的研究结果,特别是关于一个有希望的静脉干预途径,以促进这些移民的健康赋权,利用其网络中现有的社会角色:PR-indigenous ganchero。ganchero是一名寻找静脉的专家,他们提供注射服务,获得毒品或现金报酬。本研究的人种学证据表明,gancheros可以在移民波多黎各PWID中发挥减少伤害的领导作用,使标准的过量和HIV/HCV预防教育适应其社区的具体经验。最后,我们指出,为减轻移徙者的健康脆弱性,需要在文化上适当地改善减少风险的服务提供,并为改善服务提供和确定未来的研究途径提供了路线图。
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来源期刊
Contemporary Drug Problems
Contemporary Drug Problems Social Sciences-Law
CiteScore
3.30
自引率
0.00%
发文量
23
期刊介绍: Contemporary Drug Problems is a scholarly journal that publishes peer-reviewed social science research on alcohol and other psychoactive drugs, licit and illicit. The journal’s orientation is multidisciplinary and international; it is open to any research paper that contributes to social, cultural, historical or epidemiological knowledge and theory concerning drug use and related problems. While Contemporary Drug Problems publishes all types of social science research on alcohol and other drugs, it recognizes that innovative or challenging research can sometimes struggle to find a suitable outlet. The journal therefore particularly welcomes original studies for which publication options are limited, including historical research, qualitative studies, and policy and legal analyses. In terms of readership, Contemporary Drug Problems serves a burgeoning constituency of social researchers as well as policy makers and practitioners working in health, welfare, social services, public policy, criminal justice and law enforcement.
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