Needle exchange, HIV infection, and the politics of science: Confronting Canada's cocaine injection epidemic with participant observation

摘要: An epidemiological cohort study of injection drug users in Montreal documented a significant statistical association between HIV seroconversion and needle exchange patronage from 1989 to 1995. The polemics generated by this counterintuitive quantitative data demonstrate the urgent need for cross‐methodological dialogue epidemiology ethnography. Participant observation on streets multiple risks associated with compulsive behavior emotional craving often accompanying cocaine injection. Needle programs themselves cannot be expected stem infection cities where intravenous is choice. Are there unintended consequences (effets pervers) public health interventions? We an open debate improve risk‐reduction strategies. Public should expand its scientific paradigm include ethnographic documentation daily lives vulnerable street addicts. On deeper theoretical level, polem...