Prospective effects of perceived risk of developing HIV/AIDS on risk behaviors among injection drug users in Puerto Rico.

The relationship between perceived risk of developing AIDS and subsequent behavioral risk status is estimated for 1740 Puerto Rican injection drug users (IDUs). Prospective behavioral effects were examined comparing data collected at two intervals approximately 6 months apart. We estimated the association between perceived risk at baseline and risky behaviors at follow-up with unadjusted odds ratios. We confirmed the results with adjusted odds ratios using logistic regressions which included baseline risk status as well as socio-demographic and health status covariates. The analyses showed that having a high HIV/AIDS risk perception was related to subsequent sharing of needles, injection of drugs in shooting galleries and sharing of cookers. None of the tests between risk perception and sex risk behaviors showed a significance association. Increasing IDUs' perceived vulnerability to HIV/AIDS might not be effective in helping reduce HIV risk behaviors. IDUs perceiving themselves to be at high risk of AIDS might believe there is little they can do to reverse the consequences of risky behavior.

Behavioural risk factors and HIV infection of injection drug users at detoxification clinics in Puerto Rico.

BACKGROUND: The ethnic and geographical variations of AIDS prevalence among injection drug users (IDU) have highlighted the need to understand the role of the relevant risk factors in specific subpopulations of IDU. In this study we examine the factors related to seropositivity among IDU entering drug detoxification facilities in metropolitan San Juan, Puerto Rico. METHODS: From October 1990 until August 1991, 390 IDU were interviewed. Four groups of risk factors were examined: sexual practices, drug injection behaviours, risk behaviours while in US Mainland cities, and while incarcerated. A stepwise logistic regression model was used to simultaneously assess the independent effects of the behavioural risk factors on HIV seropositivity. RESULTS: Of the 342 IDU who were tested for HIV antibodies, 29.5% were seropositive. The behaviours found to be associated with seropositivity were: having sex with an IDU in the last 6 months; having injected drugs for over 5 years; and injecting with used needles while incarcerated. DISCUSSION: Public health programmes will need to establish more effective collaborative links with correctional institutions in order to reduce the spread of HIV among IDU in Puerto Rico.

PIP: In Puerto Rico between October, 1990 and August, 1991, 342 intravenous (IV) drug users at 3 detoxification clinics serving San Juan and its environs were interviewed, and blood samples were taken. Researchers wanted to determine the behavioral risk factors linked to HIV infection in a population of IV drug users in drug treatment. Most (84.9%) of the IV drug users were male. The HIV seropositivity rate was 29.5% (28.7% for males and 34% for females), which was lower than that for out-of- treatment IV drug users in metropolitan San Juan (47.5%). A stepwise logistic regression model revealed that having sexual intercourse with an IV drug user within the last 6 months (42.5% vs. 26%; adjusted odds ratio [AOR] = 1.9; p = .046), having used IV drugs for more than 5 years (32.4% for 6-10 years and 47.5% for 10 years vs. 8.8%; AOR = 4.69 and 9.64, respectively; p .001), and shooting up with used needles while imprisoned (56.8% vs. 26.2%; AOR = 3.59; p = .002) were significant behavioral risk factors of HIV infection. The significant risk factor of having sex with an IV drug user within the last 6 months suggests that sexual transmission of HIV among IV drug users in Puerto Rico is becoming as important an HIV-transmission mode as needle sharing. Since a considerable proportion of this IV drug use population in a treatment program (54.9%) has been incarcerated, and since needle sharing while in prison has an independent significant effect on HIV transmission, public health officials in Puerto Rico need to implement innovative and aggressive interventions in correctional institutions to induce risk reduction behaviors particular to IV drug inmates.

HIV/AIDS risk perception, HIV risk behaviors, and HIV seropositivity among injection drug users in Puerto Rico.

This paper assesses the factors related to self perception of developing AIDS among a group of 1,568 Puerto Rican injection drug users (IDUs). Incarceration history, years of drug injection, sharing needles, renting and borrowing needles, sharing rinse water or cooker, and having an IDU sex partner yielded a moderate association with HIV/AIDS risk perception. Use of sterile needles, shooting drugs alone, having had previous treatment episodes, and all the variables related to health status were also moderately associated with HIV/AIDS risk perception. A logistic regression model based on backwards elimination procedure, which included statistically significant variables in the bivariate analyses, yielded the variables living with children, sex with an IDU partner, shooting drugs alone, perception of health, having had a sexually transmitted disease, and results of HIV testing as statistically significant (p < 0.05).

HIV/AIDS risk perception, HIV risk behaviors, and HIV seropositivity among injection drug users in Puerto Rico

This paper assesses the factors related to self perception of developing AIDS among a group of 1,568 Puerto Rican injection drug users (IDUs). Incarceration history, years of drug injection, sharing needles, renting and borrowing needles, sharing rinse water or cooker, and having an IDU sex partner yielded a moderate association with HIV/AIDS risk perception. Use of sterile needles, shooting drugs alone, having had previous treatment episodes, and all the variables related to health status were also moderately associated with HIV/AIDS risk perception. A logistic regression model based on backwards elimination procedure, which included statistically significant variables in the bivariate analyses, yielded the variables living with children, sex with an IDU partner, shooting drugs alone, perception of health, having had a sexually transmitted disease, and results of HIV testing as statistically significant (p < 0.05)