Qualitative Research Methods in Drug Abuse and AIDS Prevention Research: An Overview Robert G. Carlson, Harvey A. Siegal, and Russel S. Falck INTRODUCTION Almost two decades ago, at the first workshop/technical review on qualitative research methods and ethnography sponsored by the National Institute on Drug Abuse (NIDA), Siegal (1977, p. 79) remarked that despite the existence of numerous excellent qualitative studies on drug abuse, “Ethnographers have had difficulty explaining precisely what they do.” In the intervening years, qualitative research methods have gained increasing importance as a systematic means of data collection and analysis that have become critical dimensions in drug abuse and AIDS research (Lambert 1990). For example, qualitative and ethnographic research are key components in NIDA’s recent program announcement, “Strategies to Reduce HIV Sexual Risk Practices in Drug Users.” Moreover, through the National AIDS Demonstration Research Program (Brown and Beschner 1993) and the Cooperative Agreement for AIDS Community-Based Outreach/Intervention research initiative, qualitative methodologists, or ethnographers. have worked increasingly on research teams composed of epidemiologists, statisticians, health educators, and psychologists, thereby promoting interdisciplinary cooperation. The recent publication of Denzin and Lincoln’s (1994a) compendium, “Handbook of Qualitative Research,” emphasizes this momentum toward interdisciplinary understanding. Despite the increased receptivity toward qualitative research methods, however, there is still some lack of clarity in what qualitative methodologists do. This chapter presents an overview of what qualitative research methods are, how they are used, and the key features required for their successful application. The ways in which qualitative methods contribute to the goal of preventing and treating drug abuse as well as associated problems, such as HIV infection, are emphasized.DEFINING QUALITATIVE RESEARCH METHODS Feldman and Aldrich (1990) date the beginnings of modem qualitative research on drugs to De Quincey’s “Confessions of an English Opium Eater,” published in 1822, in which the author took on the role of participant observer among eminent addicts and recorded his observations. Since that time, qualitative research methods have become more systematically defined in the fields of anthropology and sociology (Agar 1980, 1986; Bernard 1988; Denzin 1970, 1989; Glaser and Strauss 1967; Naroll and Cohen 1973; Pelto and Pelto 1973, 1978; Strauss and Corbin 1990; Vidich and Stanford 1994; Werner and Schoepfle 1987a, 1987b).Appropriately applied, qualitative research methods are neither soft science nor the mere journalistic reporting of values, beliefs, and behaviors. Moreover, through their capacity to expose the hidden worlds of drug users and those close to them in their holistic contexts, qualitative and quantitative methods can complement one another. As Denzin and Lincoln (1994b) note, the word “qualitative” implies an emphasis on process and an indepth understanding of perceived meanings, interpretations, and behaviors, in contrast with the measurement of the quantity, frequency, or even intensity of some externally defined variables. Since qualitative methods have different meaning for different people-depending on a person’s intellectual background, research problem, and theoretical interests-it is worthwhile to examine several definitions. According to Denzin and Lincoln (1994b, p. 2): Qualitative researchers study things in their natural settings, attempting to make sense of, or interpret, phenomena in terms of the meanings people bring to them. Qualitative research involves the studied use of a variety of empirical materials-case study, personal experience, introspective, life story, interview, observational, historical, interactional, and visual texts-that describe routine and problematic moments and meanings in individuals’ lives. The keys here are emphasis on deriving an understanding of how people perceive and construct their lives as meaningful processes, how people interact with one another and interpret those interactions in the context of the social and natural worlds, and the importance of observation in natural settings. As such, the central methods of qualitative research include interviewing people through various techniques and recording what they say, observing people in the course of their daily routines, and recording their behaviors. Strauss and Corbin (1990, pp. 17-18) offer an even broader definition of qualitative methods in the course of developing the methodology of grounded theory: “By qualitative research we mean any kind of research that produces findings not arrived at by means of statistical procedures orother means of quantification.” Strauss and Corbin (1990) note, however, that some researchers employ qualitative interviewing techniques to gather textual data that are subsequently coded and analyzed statistically; in effect, they quantify qualitative data. Other qualitative metbodologists (Bernard 1988; Trotter and Potter 1993; Weller and Romney 1988) employ systematic interviewing techniques, such as triad sorting, to produce data that are analyzed quantitatively. The results of such analyses generate an understanding of cognitive categories, or how people perceive the relationship among categories in some domain, such as HIV risk behaviors. Traditionally, the process of describing and analyzing how people perceive the world and their behaviors has been the goal of professional ethnographers trained in anthropology and sociology. While ethnography is often equated with the practice of qualitative methodologies (Brooks 1994; Werner and Schoepfle 1987a), this chapter returns to the distinction between the two (below). Wiebel (1990) identifies two reasons why qualitative methods are significant for drug abuse research. First, the construction of meaningful, structured questionnaires amenable to statistical analysis requires that a researcher possess significant familiarity with the way targeted r espondents perceive their world. Implicit, then, is the importance of conducting qualitative research in the early phases of a research project. Second, Wiebel (1990, p. 5) suggests that “Qualitative research is often the only means available for gathering sensitive and valid data from otherwise elusive populations of substance abusers.” By