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Prevention and intervention studies show that risk behaviors leading to HIV infection are increasing among older users, particularly among the socially vulnerable. Yet older adults remain an underresearched population of drug users and little is known about their risk behaviors. Our aim is to address this gap in knowledge on older users by comparing contextual factors that influence risk behaviors and harm reduction strategies practiced by older drug users living in different communities. This study is based on ethnographic fieldwork in suburban and inner-city neighborhoods in a large metropolitan area in the southeastern United States. Interviewers conducted face-to-face, in-depth, life history interviews with 69 older adults (ages 45 and older) who used heroin, cocaine, and\/or methamphetamine. Findings show that while risk behaviors were similar among older adult drug users living in suburban and inner-city environments, the provision of harm reduction education and paraphernalia varied widely. The results show the need for the expansion of harm reduction services focused on older adult drug users who are homeless, uninsured, or socially isolated. This application-oriented research will inform health care and treatment providers and generate new directions for future collaborative harm reduction services aimed to decrease the spread of HIV and other infectious diseases associated with drug use.<\/jats:p>","DOI":"10.1177\/1936724411431035","type":"journal-article","created":{"date-parts":[[2017,7,14]],"date-time":"2017-07-14T00:04:12Z","timestamp":1499990652000},"page":"72-91","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["A Contextual Comparison of Risk Behaviors among Older Adult Drug Users and Harm Reduction in Suburban Versus Inner-city Social Environments"],"prefix":"10.1177","volume":"6","author":[{"given":"Miriam W.","family":"Boeri","sequence":"first","affiliation":[{"name":"Kennesaw State University, Kennesaw, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin D.","family":"Tyndall","sequence":"additional","affiliation":[{"name":"Vanderbilt University, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,3,1]]},"reference":[{"key":"bibr1-1936724411431035","volume-title":"Ripping and Running: A Formal Ethnography of Urban Heroin Addicts","author":"Agar Michael","year":"1973"},{"key":"bibr2-1936724411431035","volume-title":"The Professional Stranger: An Informal Introduction to Ethnography","author":"Agar Michael","year":"1980"},{"key":"bibr3-1936724411431035","volume-title":"Social Learning and Social Structure: A General Theory of Crime and Deviance","author":"Akers Ronald L.","year":"1998"},{"key":"bibr4-1936724411431035","doi-asserted-by":"publisher","DOI":"10.2307\/2094592"},{"key":"bibr5-1936724411431035","volume-title":"Strained Suburbs: The Social Service Challenges of Rising Suburban Poverty","author":"Allard Scott W.","year":"2010"},{"issue":"1","key":"bibr6-1936724411431035","first-page":"46","volume":"22","author":"Alwin Duane F.","year":"1998","journal-title":"Generations"},{"key":"bibr7-1936724411431035","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2003.00388.x"},{"key":"bibr8-1936724411431035","doi-asserted-by":"publisher","DOI":"10.1097\/00126334-200306012-00001"},{"key":"bibr9-1936724411431035","doi-asserted-by":"publisher","DOI":"10.1086\/221326"},{"issue":"2","key":"bibr10-1936724411431035","first-page":"43","volume":"69","author":"Benshoff John J.","year":"2003","journal-title":"Journal of Rehabilitation"},{"key":"bibr11-1936724411431035","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780195083316.003.0007"},{"key":"bibr12-1936724411431035","volume-title":"Pathways from Heroin Addiction: Recovery without Treatment","author":"Biernacki Patrick","year":"1986"},{"key":"bibr13-1936724411431035","volume-title":"Substance Abuse among Baby Boomers","author":"Blow Frederic C.","year":"2000"},{"key":"bibr14-1936724411431035","first-page":"212","volume-title":"Qualitative Methods in Drug Abuse and HIV Research","author":"Bluthenthal Ricky N.","year":"1995"},{"key":"bibr15-1936724411431035","unstructured":"Boeri Miriam W. 2002. \u201cI\u2019m An Addict but I Ain\u2019t no Junkie: An Ethnographic Analysis of the Drug Career of Baby Boomers.\u201d PhD dissertation, Department of Sociology, Georgia State University, Atlanta, GA."},{"key":"bibr16-1936724411431035","doi-asserted-by":"publisher","DOI":"10.17730\/humo.63.2.p36eqah3w46pn8t2"},{"key":"bibr17-1936724411431035","doi-asserted-by":"publisher","DOI":"10.1177\/193672440700100108"},{"key":"bibr18-1936724411431035","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/48.5.637"},{"key":"bibr19-1936724411431035","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-682X.2006.00154.x"},{"key":"bibr20-1936724411431035","doi-asserted-by":"publisher","DOI":"10.3109\/16066359.2011.566654"},{"key":"bibr21-1936724411431035","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2008.01.021"},{"key":"bibr22-1936724411431035","doi-asserted-by":"publisher","DOI":"10.4135\/9781483348919.n7"},{"issue":"3","key":"bibr23-1936724411431035","first-page":"389","volume":"3","author":"Capel W. 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