This article describes and compares distributions of drug-scene roles, frequency of engaging in role behaviors, and relationships of role-holding to high-risk behaviors and sexual partnerships among Puerto Rican injection drug users in New York and Puerto Rico. For this study 561 street-recruited injection drug users in East Harlem, New York, and 312 in Bayamón, Puerto Rico were asked the number of days (in the last 30) in which they earned money or drugs in each of seven drug-scene roles; and about behaviors and egocentric risk partner characteristics in the last 30 days. East Harlem subjects were more likely to get resources by selling drugs and syringes, and buying drugs for someone else; Bayamón subjects were more likely to be "hit doctors," buy needles for others, operate a shooting gallery, or escort others to shooting galleries. All roles were part-time except shooting gallery management in East Harlem. About 27% of respondents at each site engaged in two or more roles. Many roles were associated with increased odds of injecting more than twice a day, receptive syringe sharing, distributive syringe sharing, receptive paraphernalia sharing, and having a drug-injecting sex partner. Drug-scene role structures vary between cities. Most roles are part-time pursuits. Role-holders have higher-risk behaviors and sexual partnerships than other drug injectors. Although further research is needed, drug-scene role-holders should be targeted for interventions to affect their own risk and their communications with others.
"The finding that IDUs who ever injected drugs in Mexico were more likely to have transported or packaged drugs implies a connection to the illicit drug trade. Various roles in the drug scene, such as selling drugs, have been associated with elevated odds of injection drug use and syringe sharing [12, 26]. Another study from Asia found similar results along a major drug supply route: IDUs who traveled from China, where drugs were scarce, to a region in Vietnam where drugs were plentiful, were more likely to cross the border to purchase drugs than non-IDUs . "
[Show abstract][Hide abstract] ABSTRACT: We examined correlates of ever injecting drugs in Mexico among residents of San Diego, California. From 2007 to 2010, injecting drug users (IDUs) in San Diego underwent an interviewer-administered survey. Logistic regression identified correlates of injection drug use in Mexico. Of 302 IDUs, 38% were Hispanic, 72% male and median age was 37; 27% ever injected in Mexico; 43% reported distributive syringe sharing there. Factors independently associated with ever injecting drugs in Mexico included being younger at first injection, injecting heroin, distributive syringe sharing at least half of the time, and transporting drugs over the last 6 months. One-quarter of IDUs reported ever injecting drugs in Mexico, among whom syringe sharing was common, suggesting possible mixing between IDUs in the Mexico-US border region. Prospective studies should monitor trends in cross-border drug use in light of recent Mexican drug policy reforms partially decriminalizing drug possession.
Journal of Immigrant and Minority Health 03/2011; 14(2):281-6. DOI:10.1007/s10903-011-9462-9 · 1.16 Impact Factor
"In 2002, 45% of Puerto Rican IDUs in New York City were infected with HIV along with 44% of Black IDUs and 32% of White IDUs . Among Puerto Rican IDUs, access to sterile syringes , incarceration , residential status , drug scene roles , and sexual identity  have been previously identified as important factors that influence HIV transmission. Comparatively, Mexican Americans have been shown to have higher rates of drug injection and lower rates of sharing injection paraphernalia than Puerto Ricans [17, 18]. "
[Show abstract][Hide abstract] ABSTRACT: Latinos in the United States are an ethnically diverse group disproportionately affected by HIV/AIDS. We describe HIV seroprevalence, HIV risk behaviors and utilization of health services among Mexican American injection drug users (IDUs) in California (n = 286) and compare them to White (n = 830) and African American (n = 314) IDUs. Study participants were recruited from syringe exchange programs (n = 24) in California. HIV seroprevalence among Mexican Americans (0.5%) was dramatically lower than Whites (5%) and African Americans (8%). Mexican Americans reported fewer sex-related risks than Whites and African Americans though injection-related risks remained high. Compared to Whites, Mexican Americans were more likely to participate in drug treatment during a 6 month period (AOR 1.5, 95% CI 1.1, 2.0) but less likely to receive any health care (AOR 0.6, 95% CI 0.5, 0.8). Exploring cultural and structural factors among Mexican American IDUs may offer new insights into how to maintain low rates of HIV seroprevalence and reduce barriers to health care utilization.
AIDS and Behavior 12/2009; 15(1):95-102. DOI:10.1007/s10461-009-9614-2 · 3.49 Impact Factor
"Several studies tested for both gonorrhea and chlamydia in drug users (Bachmann et al., 2000; Friedman et al., 2003; Gunn et al., 2005; Hwang et al., 2000; Lally et al., 2002; Latka et al., 2001; Liebschutz et al., 2003; Plitt et al., 2005; Ross et al., 2002). For gonorrhea, a prevalence rate ranging from 1% to 3% was reported in those studies. "
[Show abstract][Hide abstract] ABSTRACT: Prevention of heterosexual transmission of HIV between and from drug users is important for controlling the local and global HIV heterosexual epidemic. Sex risk reduction interventions and health-related interventions are important for reducing the sex risk behaviors of drug users. Sex risk reduction interventions address individual-level, peer-level, and structural-level determinants of risk reduction. Health-related interventions include HIV counseling and testing, prevention and treatment of sexually transmitted diseases, and delivery of highly active antiretroviral therapy. It is important to adapt effective interventions implemented in resource-rich countries to the realities of the resource-constrained settings and to address relevant contextual factors.
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