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Black Adolescent Crack Users in Oakland: No Quick Fix

Barbara G. Silverman, MD, MPH
JAMA. 1990;264(3):337. doi:10.1001/jama.1990.03450030053026.
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To the Editor.—  The article by Dr Fullilove et al1 provides an excellent summary of those risk behaviors that increase the likelihood of teenaged "crack" cocaine users becoming infected with sexually transmitted diseases, including human immunodeficiency virus disease. The risk behaviors elicited, including exchanging sexual favors for drugs or money, engaging in sexual relations while under the influence of drugs or alcohol, and impulsive behavior, clearly do not lend themselves to a "quick fix" precisely because they are so fundamentally linked to drug dependency and the complex psychosocial problems of these adolescents.While condoms are an adjunct to "safe sex," they are of little value in the absence of responsible behavior, not only in the choice of sexual partners but in the use of the condoms themselves. Furthermore, many of these youngsters, such as the addicted girl exchanging sexual favors for money or drugs, lack the authority in

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