Understanding differences in HIV/HCV prevalence according to differentiated risk behaviors in a sample of PWID in rural Puerto Rico

BACKGROUND:

Blood contained in needles and injection equipment has been identified as a vector for HIV and HCV transmission among people who inject drugs (PWID). Yet, there is often a wide discrepancy in prevalence for both viruses. While microbiological differences between viruses influence prevalence, other variables associated with the way drugs are acquired and used, also play a role.

METHODS:

Respondent-driven sampling (RDS) methods recruited a sample of 315 current intravenous drug users in rural Puerto Rico. Information about type and frequency of use, HIV and HVC risk behaviors (sharing needles, cookers, cotton, and water), sexual behaviors, and alcohol use was collected. HIV and HCV statuses were assessed via rapid antibody tests. T tests compare means of participants who tested positive (reactive) to those who tested negative. Logistic regression analyses were used to validate the association of the risk factors involved.

RESULTS:

Tests showed a significant difference in HIV (6 %) and HCV (78.4 %) prevalence among a population of current PWID. The main riskbehaviors in HCV transmission are the sharing of injection "works", (e.g., cookers, cotton, and water). Sharing works occurred more than twice as often as the sharing of needles, and HCV+ and HCV- individuals reported the same needle sharing habits.

CONCLUSIONS:

Washing and rinsing injection works with water seems to prevent HIV transmission, but it is unable to prevent HCV infection. While education about the need to clean injection equipment with bleach might be beneficial, equipment sharing-and the subsequent risk of HVC-might be unavoidable in a context where participants are forced to pool resources to acquire and use intravenous drugs.

Descriptive statistics

	Mean/%	SD	N
% HIV positive (INSTI Rapid Test)	6.0 %		315
% HCV positive (OraQuick Rapid Test)	78.4 %		315
% Male	90.5 %		315
% Born in Puerto Rico	93.0 %		315
Age (years)	41.8	(10.07)	315
Annual per capita income	$4452	($3200)	311
% Unemployed	85.4 %		314
% Currently homeless	21.9 %		314
% Graduate high school (or higher)	52.4 %		315
% Married or living together as married	22.2 %		315
% Injected 4 or more times per day	39.7 %		315
% Injected 2–3 times per day	39.7 %		315

Full article at:   http://goo.gl/xAXsqk

By:  Abadie R1, Welch-Lazoritz M2, Gelpi-Acosta C3, Reyes JC4, Dombrowski K5.

• 1Department of Sociology, University of Nebraska-Lincoln, 206 Benton Hall, Lincoln, NE, 68588, USA. rabadie2@unl.edu.
• 2Department of Sociology, University of Nebraska-Lincoln, 206 Benton Hall, Lincoln, NE, 68588, USA. mwelch2@unl.edu.
• 3Social Science Department, LaGuardia Community College, 31-10 Thomson Ave., Long Island City, NY, 11101, USA. camilagelpi@gmail.com.
• 4Department of Biostatistics and Epidemiology, University of Puerto Rico, 365067, San Juan, PR, 00936, USA. juan.reyes5@upr.edu.
• 5Department of Sociology, University of Nebraska-Lincoln, 206 Benton Hall, Lincoln, NE, 68588, USA. kdombrowski2@unl.edu.
• Harm Reduct J. 2016 Mar 8;13(1):10. doi: 10.1186/s12954-016-0099-9. 

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