Bourgois P
Department of Epidemiology and Biostatistics, University of California, San Francisco, 94143, USA.
Subst Use Misuse. 1998 Sep;33(11):2323-51. doi: 10.3109/10826089809056260.
Ethnographic immersion among homeless heroin addicts in San Francisco documents far more risky practices than the public health literature routinely reports. The logics of street-based income-generating strategies and the moral economy of social networking among self-identified "dope fiends" results in almost daily shares of drug preparation paraphernalia. Public health researchers need to reconceptualize their psychological behaviorist paradigm of "individual health risk behavior" because the pragmatics of income-generating strategies and the social symbolic hierarchies of respect, identity, and mutual dependence shape risky behavior. The explanatory potentials and the applied interventions that participant-observation anthropological approaches could bring to epidemiological public health research have not been utilized effectively in the field of HIV prevention and substance use. The accuracy of quantitative public health databases and our understanding of the who/why/how/where of HIV infection could be improved by a cross-methodological dialogue with participant-observation fieldworkers and by a greater theoretical sophistication with respect to power, violence, and extreme social marginalization.
对旧金山无家可归的海洛因成瘾者进行的人种志沉浸式研究记录了比公共卫生文献通常报道的更多的危险行为。基于街头的创收策略逻辑以及自称“瘾君子”的人之间社交网络的道德经济，导致几乎每天都有毒品制备用具的共享。公共卫生研究人员需要重新构想他们关于“个体健康风险行为”的心理行为主义范式，因为创收策略的实用主义以及尊重、身份和相互依赖的社会象征等级制度塑造了危险行为。参与观察人类学方法可以为流行病学公共卫生研究带来的解释潜力和应用干预措施，在艾滋病毒预防和药物使用领域尚未得到有效利用。通过与参与观察实地工作者进行跨方法对话，以及在权力、暴力和极端社会边缘化方面提高理论复杂性，可以提高定量公共卫生数据库的准确性以及我们对艾滋病毒感染的对象/原因/方式/地点的理解。
