ABSTRACT
As the face of the HIV/AIDS pandemic in the United States changes from that of a middle class white gay or bisexual male to that of a poor black or Latino heterosexual male, female or baby, it becomes increasingly clear that interventions which may have been successful in producing risk-reduction behavior change with gay men are showing scant success with active drug users. Part of the problem is our cultural assumption that drugs and drug use are intrinsically bad, unhealthy, and pathological. The general public, drug treatment workers, and other health care professionals believe this and often the drug user him- or herself has internalized this idea. People need to feel worthwhile and empowered in order to make difficult changes in their lives; starting from the perspective that what one does is bad – or that one’s entire life is pathological – is a setup for failure.
