Drug-scene roles and HIV risk among Puerto Rican injection drug users in East Harlem, New York and Bayamón, Puerto Rico.
ABSTRACT 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.
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ABSTRACT: We compared drug-related behaviors, including initiation of drug use, among street youth residing in two adjacent neighborhoods in Vancouver. One neighborhood, the Downtown Eastside (DTES), features a large open-air illicit drug market. In multivariate analysis, having a primary illicit income source (adjusted odds ratio [AOR]=2.64, 95% confidence interval [CI]: 1.16-6.02) and recent injection heroin use (AOR=4.25, 95% CI: 1.26-14.29) were positively associated with DTES residence, while recent non-injection crystal methamphetamine use (AOR: 0.39, 95% CI: 0.16-0.94) was negatively associated with DTES residence. In univariate analysis, dealing drugs (odds ratio [OR]=5.43, 95% CI: 1.24-23.82) was positively associated with initiating methamphetamine use in the DTS compared to the DTES. These results demonstrate the importance of considering neighborhood variation when developing interventions aimed at reducing drug-related harms among street-involved youth at various levels of street entrenchment.Health & Place 09/2010; 16(5):1061-7. · 2.42 Impact Factor
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ABSTRACT: A large body of research has highlighted practices and rituals that characterise injecting drug use and behavioural and environmental risks that can contribute to the transmission of blood-borne viruses. Compared with other injecting practices, considerably less is known about peer injecting, i.e. receiving or giving injections, particularly the social context in which it occurs. In this article, we explore peer injecting and injecting order at initiation into injecting drug user (IDU) and during subsequent injection episodes. Using data from semi-structured interviews, we highlight the experiences of 41 males and females who had received injections from other IDUs. Respondents were recruited through various strategies, largely chain referral. The results suggest gendered similarities as well as differences in terms of peer injecting, the order of injection and micro-risk contexts for blood-borne viruses.Journal of Substance Use 01/2013; 18(1):31-45. · 0.48 Impact Factor
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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. · 1.16 Impact Factor