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A new epidemic of syphilis in the Portland, Oregon metropolitan region mirrors a national trend in the United States. The epidemic is centered in urban areas, is associated with heterosexual transmission, and disproportionately affects people of color, especially African-Americans.
The epidemic has been linked to sexual activity among users of crack cocaine, and particularly to the practice of trading sex and crack. Here, we report an analysis of in-depth interviews of 40 respondents, of whom 31 have used crack cocaine, 12 have experience as professional sex workers prostitutesand 12 are confirmed recent syphilis cases or their sexual contacts.
All about trade
These respondents confirm that sexual activity involving multiple anonymous partners often takes place within the context of crack cocaine use. They also describe sexual activity among more casual users of the drug.
But respondents present themselves as having maintained an adherence to common American values regarding cleanliness, morality, and sexual behavior. A person is more likely to be judged clean if he or she is known to come from a nice family, has a pleasant demeanor, or appears concerned about self-control. Such people are seen as fundamentally decent, and therefore less likely to have syphilis, a disease associated with deterioration, tearing down, dirtiness and disordering.
Thus, respondents use conceptions of cleanliness and morality in constructing definitions of high- and low-risk sexual behavior, as they negotiate a life that endangers their sense of moral control. In doing this, they invoke beliefs and values central to the dominant culture surrounding them.
This points to the limits of defining crack cocaine users, and other communities of drug users, as being culturally different from the rest of us. View PDF. Access through your institution Purchase PDF. Add to Mendeley Share.
Abstract A new epidemic of syphilis in the Portland, Oregon metropolitan region mirrors a national trend in the United States. Keywords sexually transmitted diseases. Recommended articles Citing articles 0.