Reciprocity and Exploitation: Social Dynamics in Private Drug use Sites

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Abstract
The Study of High Risk Drug Use Settings for HIV Prevention was designed to increase knowledge of urban social contexts in which drugs are consumed. In this article, we use ethnographic methods to focus on one subtype of drug use setting in Hartford, Connecticut, private sites with gatekeepers. We analyze the social interactions of drug users who use these sites to explore the contradictory social processes that sometimes facilitate and at other times impede intervention efforts. Gatekeepers are often interested in attracting customers to their “business” and therefore may be willing to provide ongoing site-based HIV prevention education and materials. On the other hand, exploitative business exchanges contradict ideals of reciprocity and may undermine trust between gatekeepers and drug users impeding harm reduction efforts. Further, being the gatekeeper of a drug use site often accelerates gatekeepers' addictions, making it difficult for them to implement harm reduction strategies.