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SNRG NHBS team concludes third year with 500 IDU interviews

On November 16, 2012, SNRG’s NYC National HIV Behavioral Surveillance (NHBS) IDU3 team concluded its third tri-annual round of interviews, and HIV and hepatitis B/C testing, with injection drug users (IDU) in New York City. More than 500 study participants were interviewed and tested at one of the three NYC NHBS field sites in Bushwick, Brooklyn; the Lower East Side, in Manhattan; and Mott Haven, in the Bronx.The NHBS study is a national CDC study conducted in cities with high rates of HIV prevalence that each year recruits a sample of a population at high risk for HIV (IDU, men who have sex with men, and heterosexuals at elevated risk for HIV). As in many SNRG studies, the study used respondent-driven sampling (RDS), a chain-referral strategy where study participants recruit future study participants. HIV and hepatitis B and C tests, and risk-reduction counseling were provided to all participants who agreed to testing. Participants were compensated for study participation and recruiting. Following the cyclical design of the NHBS, the SNRG NHBS team is now preparing for 2013 data collection with heterosexuals at elevated risk for HIV, in collaboration with the NYC Department of Health and Mental Hygiene, and the CDC. For a map of the recruitment click here.

Recent Submission: Journal of Anthropology

“Out on the Land: Income, Subsistence Activities and Food Sharing Networks in Nain, Labrador”

Kirk Dombrowski
Emily Channell
Bilal Khan
Joshua Moses
Evan Misshula

Abstract: Throughout the history of Inuit ethnography, a major concern has been how and to what extent contemporary Inuk participate in and depend on subsistence activities, particularly in the context of increasing wage employment and growing participation in the cash economy. This paper provides an analysis of these activities in the predominately Inuit community of Nain, Labrador. Using social network analysis and demographic information collected between January and June 2010, we examine the interconnections between subsistence activities – obtaining “country food” through activities such as hunting and fishing – with access to the means of obtaining subsistence resources (such as snow mobiles, cabins and boats), employment status, and income. Our data indicate that individuals with higher employment status and income tend to be more central to the network of subsistence food sharing, but not because they have greater access to hunting tools or equipment (they do not). We conclude that those individuals who play the most central role in the network are those who are financially able to do so, regardless of access to hunting tools/means.
Keywords: Inuit, Subsistence, Employment, Social Network Analysis, Labrador

Article and Special Issue of Dialectical Anthropology

Published by Dialectical Anthropology — online first
“Peeling the Onion: Domestically Trafficked Minors and Other Sex Work Involved Youth”
by Amber Horning

A critical review of three recent works addressing human trafficking among minors: Rachel Llyod’s Girls Like Us, Meredith Dank’s The Commercial Sexual Exploitation of Children, and Ric Curtis, Karen Terry, Meredith Dank, Kirk Dombrowski and Bilal Khan’s report to the National Institute of Justice: The Commercial Sexual Exploitation of Children in New York City. Drawing on her own research with several dozen young pimps in New York City, Horning argues that these works together suggest an urgent need to refocus resources on understanding the problems that youth involved in sex work face including a lack of support, job opportunities and resources, and clearly defined exit routes.

Special Issue of Dialectical Anthropology: Anti-Anti-Trafficking? – Towards an Ethnography of Human Trafficking
due for publication in March
Editors Ed Snajdr and Anthony Marcus
This special issue of Dialectical Anthropology aims to critically examine how human trafficking discourses, laws and interventions complicate efforts to define, address and engage with the issue and how these responses and engagements problematize ideas of agency, consent and individual autonomy. These themes are explored from the perspective of anthropology and in particular through the lens of ethnographic research conducted in the field, both from its peripheries and among the central networks of sex workers, forced laborers and the organizations, and governments clamoring to assist them. From the favelas of Brazil or the steppes of Kazakhstan to US juvenile offender assessment centers, the digital networks of Craigslist and Backpage, or a military base in Bosnia, these ethnographic engagements seek to shed a critical light on the nuances, narratives and conundrums of human trafficking and the policies and practices devised to eradicate it.

Submitted to Qualitative Inquiry

Reducing Recurrent Homelessness: Some Methodological Lessons from the Critical Time Intervention Experiment

Anthony Marcus Ph.D
City University of New York
Social Networks Research Group

It is well established that quantitative surveys and qualitative interviews can easily complement each other. However, as one moves deeper into their respective “territories”, towards randomized control trials and ethnography the potential for misunderstanding increases. This article examines the tensions and possibilities in this relationship through the first ethnographic assessment of Critical Time Intervention (CTI), a randomized clinical trial of an experiment in reducing homelessness among mentally ill men in New York City in the early 1990s. CTI has had a decade of positive quantitative assessments, praise from President George W. Bush’s 2003 New Freedom Commission on Mental Health, and replication attempts, but its ethnographic data has not been used in evaluation. This article seeks to correct this omission and reveal some of the broader challenges to creating a qualitative/quantitative synthesis.

Recent RO1 Grant Submission: Addressing HCV-related hepatocellular carcinoma: the current and future epidemics

PI: Holly Hagan (NYU)
Investigators: Bilal Khan and Kirk Dombrowski

Hepatitis C virus (HCV)-related deaths now exceed HIV-related deaths in the US. Throughout the world, HCV is hyperendemic in people who inject drugs (PWID). New outbreaks of acute HCV infection are unfolding in HIV-positive men who have sex with men (MSM) and in 15-24 year olds who have transitioned from abuse of prescription opioids to illicit opiate injection. In patients with chronic HCV infection, 20-25% will develop liver disease which may manifest as cirrhosis, liver failure or hepatocellular carcinoma (HCC). The prognosis for HCC is extremely poor, and HCV is the chief etiologic agent for this type of cancer. Recent discoveries in HCV prevention and treatment provide a great opportunity to reverse the trend toward increasing rates of HCV, HCV/HIV co-infection, and HCC. This study will use the methods of Implementation Science – research synthesis, mathematical modeling and simulation, and comparative effectiveness analyses – to determine how best to constitute a portfolio of interventions for the prevention and control of HCV and its consequences while taking into account limited resources and underlying epidemiologic and social network features. A dissemination plan will make extensive use of technology, including social media, and guidance from key stakeholders. These are our specific aims:
1. Synthesize evidence characterizing a) transition from misuse of prescription opioids to drug injection, b) HCV epidemiology and prevention for PWID and HIV+ MSM, and c) progression and treatment of HCV disease in these two groups, to derive best estimates to populate our HCV natural history and transmission models.
2. Use agent-based modeling to estimate the effects of scale-up of individual and combined prevention- and treatment-related interventions on HCV transmission and natural history in PWID and HIV+MSM.
3. Determine the combination of interventions for particular budget and epidemiologic scenarios that a) minimizes acute and chronic HCV infections, including HIV/HCV co-infection, b) prevents the greatest number of cases of HCV-related HCC and other serious sequelae, c) maximizes life expectancy and quality-adjusted life expectancy and d) reduces health disparities.
4. In collaboration with our Dissemination Advisory Board, apply an integrated knowledge-exchange approach to providing our target audiences (policymakers, public health and harm reduction practice communities, PWID and HIV+MSM) with the knowledge and tools to implement evidence-based HCV control strategies or reduce personal risk of infection and its consequences.
The broad objective of this study is to provide an evidence base to guide allocation of scarce public resources in the US and other countries where HCV is principally transmitted among PWID. This will be accomplished by synthesizing, modeling and translating very recent developments in HCV epidemiology, prevention and treatment into practical tools to optimize population health.