HIV transmission behaviors in jail/prison among puerto rican drug injectors in New York and Puerto Rico.
ABSTRACT This study examined HIV risk behavior in jail/prison among Puerto Rican drug injectors in New York (NY, n = 300) and Puerto Rico (PR, n = 200), and its relationship with later drug and sex risk behaviors. During 3 years prior to interview, 66% of NY and 43% of PR samples were incarcerated at least once. While incarcerated, 5% of NY and 53% of PR injected drugs. Few reported engaging in sex inside jail/prison (5% in both sites). Of those who engaged in risk behaviors in jail/prison, almost all reported having unprotected sex and sharing injection equipment. The impact of jail/prison risk behaviors on risk behaviors after release differed between the two sites: they were more related to subsequent sex risk behaviors in NY, and subsequent injection risk behaviors in PR. The findings indicate a need for effective drug treatment programs inside jail/prisons to reduce HIV-related risk behaviors among drug injectors during incarceration and after release.
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ABSTRACT: No adequate data exist on patterns of injection drug use (IDU) prevalence over time within racial/ethnic groups in U.S. geographic areas. The absence of such prevalence data limits our understanding of the causes and consequences of IDU and hampers planning efforts for IDU-related interventions. Here, we (1) describe a method of estimating IDU prevalence among non-Hispanic Black and non-Hispanic White adult residents of 95 large U.S. metropolitan statistical areas (MSAs) annually over an 11-year period (1992–2002); (2) validate the resulting prevalence estimates; and (3) document temporal trends in these prevalence estimates. IDU prevalence estimates for Black adults were calculated in several steps: we (1) created estimates of the proportion of injectors who were Black in each MSA and year by analyzing databases documenting injectors’ encounters with the healthcare system; (2) multiplied the resulting proportions by previously calculated estimates of the total number of injectors in each MSA and year (Brady et al., 2008); (3) divided the result by the number of Black adults living in each MSA each year; and (4) validated the resulting estimates by correlating them cross-sectionally with theoretically related constructs (Black- and White-specific prevalences of drug-related mortality and of mortality from hepatitis C). We used parallel methods to estimate and validate White IDU prevalence. We analyzed trends in the resulting racial/ethnic-specific IDU prevalence estimates using measures of central tendency and hierarchical linear models (HLM). Black IDU prevalence declined from a median of 279 injectors per 10,000 adults in 1992 to 156 injectors per 10,000 adults in 2002. IDU prevalence for White adults remained relatively flat over time (median values ranged between 86 and 97 injectors per 10,000 adults). HLM analyses described similar trends and suggest that declines in Black IDU prevalence decelerated over time. Both sets of IDU estimates correlated cross-sectionally adequately with validators, suggesting that they have acceptable convergent validity (range for Black IDU prevalence validation: 0.27 < r < 0.61; range for White IDU prevalence: 0.38 < r < 0.80). These data give insight, for the first time, into IDU prevalence trends among Black adults and White adults in large U.S. MSAs. The decline seen here for Black adults may partially explain recent reductions in newly reported cases of IDU-related HIV evident in surveillance data on this population. Declining Black IDU prevalence may have been produced by (1) high AIDS-related mortality rates among Black injectors in the 1990s, rates lowered by the advent of HAART; (2) reduced IDU incidence among Black drug users; and/or (3) MSA-level social processes (e.g., diminishing residential segregation). The stability of IDU prevalence among White adults between 1992 and 2002 may be a function of lower AIDS-related mortality rates in this population; relative stability (and perhaps increases in some MSAs) in initiating IDU among White drug users; and social processes. Future research should investigate the extent to which these racial/ethnic-specific IDU prevalence trends (1) explain, and are explained by, recent trends in IDU-related health outcomes, and (2) are determined by MSA-level social processes.Journal of Urban Health 85(6):826-856. · 1.89 Impact Factor
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ABSTRACT: Background: Risk for HIV is primarily associated with two behaviors of unprotected sexual contact and injected drug use (IDU). This study was carried out to determine the demographic data and high-risk behaviors in HIV positive individuals in southern Iran. Patients and methods: Totally, 304 HIV-infected individuals referring to Center for Counseling of Behavioral Changes in Shiraz entered our study. Their demographic data and risk factors for HIV (injection addiction, unprotected sexual contact, and blood transfusion) were recorded. Blood specimens were provided and tested for HIV antibodies using an enzyme-linked immunosorbent assay (ELISA) at Fars Blood Transfusion Organization were carried out. Specimens reactive upon enzyme-linked immunosorbent assay were confirmed by western blot assay. Results: Study population included 269 males and 35 females mostly aged 25-34 years. Totally, 60% of females and 30.8% of males were married, while 80.3% of males and 74.3% of females belonged to poor-educated level (had not got diploma). Of 269 males, 247 (91.8%) had been jailed. The risk behaviors were as follow: 40.8% IDU, 16.4% unprotected sexual contact, 32.6% both IDU and unprotected sexual contact, 1.6% blood transfusion, 7.9% other high risk behaviors including tattooing, shared blade and knife injury and 0.7% had unknown high risk behavior. Maternal transmission was not observed. Conclusion: It seems that establishing Drop In Center for giving free disposed syringes to IDUs, training a correct injection and a good dressing service, bathroom, nutrition and methods replacement therapy would be effective means to reduce high risk behaviors.Iranian Journal of Clinical Infectious Diseases 01/2008; 3:209-213.
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ABSTRACT: Using a sample of 280 Puerto Rican drug users with a history of incarceration residing in Massachusetts, we explore whether a significant association exists between social and economic factors (maintaining social network contacts, receiving public assistance) and lifetime incarceration. Analysis of survey data using regression methods shows that respondents who live in their own home, receive public assistance, and have recent familial contact are significantly less likely to have been incarcerated in the past 6 months. Among study participants, men and those who initiated heroin use at younger ages are more likely to have greater lifetime incarceration totals. Practice implications are discussed.Journal of Ethnicity in Substance Abuse 01/2013; 12(2):179-95.