Latent Risk Subtypes Based on Injection and Sexual Behavior Among People Who Inject Drugs in Rural Puerto Rico

Hautala, Dane; Abadie, Roberto; Thrash, Courtney; Reyes, Juan C.; Dombrowski, Kirk

doi:10.1111/jrh.12262

Cited by 3 publications

(2 citation statements)

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“…In the multi-phase parent study, 315 participants were initially recruited via respondent driven sampling (RDS) for phase 1. Analysis of phase 1 RDS recruitment has been previously published, offering additional demographic and sociometric data about PWID in rural Puerto Rico before the arrival of Hurricane Maria [32,33]. In phase 2 of the project, 33 participants from phase 1 were asked to complete extensive social network interviews, and their social connections were then in turn invited to participate in phase 2, resulting in 110 interviews.…”

Section: Data Source and Samplementioning

confidence: 99%

Substance use, injection risk behaviors, and fentanyl-related overdose risk among a sample of PWID post-Hurricane Maria

et al. 2022

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Background While natural disasters like hurricanes are increasingly common, their long-term effects on people who inject drugs are not well understood. Although brief in duration, natural disasters can radically transform risk environments, increasing substance use and drug-related harms. Methods Based on a study of people who inject drugs (PWID) and injection risk behaviors in rural Puerto Rico, the present study uses data from two different phases of the parent study. Data for 110 participants were collected from December 2015 to January 2017, soon before Hurricane Maria landed in September 2017; the 2019 phase, in the aftermath of the hurricane, included a total of 103 participants. The present study’s main analyses used data from 66 PWID who participated in both the pre-Maria and post-Maria interviews (66 individuals measured at two time points, for a total of 132 observations), using mixed-effects binomial logistic regression to examine recent overdose experiences pre- and post-Maria. A separate descriptive analysis included all 103 participants from the 2019 interview. Results After Hurricane Maria, some declines in injection frequency were observed (the percentage of people reporting injecting monthly or less increased from 3.0% before Hurricane Maria to 22.7% after Hurricane Maria). However, fewer PWID reported using a new needle for most or all injections. In the pre-Maria interview, 10.6% of participants indicated they had experienced an overdose during the year of the interview and/or the calendar year prior, and this figure increased to 24.2% in the post-Maria interview. In the regression analysis, the odds of reporting an overdose during the interview year and/or calendar year prior were three times as high post-Maria, relative to pre-Maria (odds ratio 3.25, 95% confidence interval 1.06–9.97). Conclusion Substance use patterns, injection risk behaviors, and overdose episodes and deaths differed after Hurricane Maria, relative to before the hurricane, yet it is unclear to what extent these changes also reflect the simultaneous arrival of fentanyl. In preparation for future natural disasters, it is imperative to strengthen the health infrastructure by enhancing access and curbing barriers to syringe services programs and medications for opioid use disorder, particularly in rural or underserved locations.

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Section: Data Source and Samplementioning

confidence: 99%

Substance use, injection risk behaviors, and fentanyl-related overdose risk among a sample of PWID post-Hurricane Maria

et al. 2022

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“…Polysubstance use among Puerto Rican PWID has been associated with increased injection risk behavior compared to use of primarily one injection substance (Hautala et al, 2017). Others suggest that the use of alcohol with injection drugs also increases injection risk behavior (Matos et al, 2004; Welch-Lazoritz et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Rural and urban comparisons of polysubstance use profiles and associated injection behaviors among people who inject drugs in Puerto Rico

Hautala

Abadie

Khan

et al. 2017

Drug and Alcohol Dependence

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Introduction In contrast to urban populations, little is known about polysubstance use among rural people who inject drugs (PWID), particularly in Puerto Rico where injection drug use and related health consequences are prevalent. The aim of the study is to compare injection and non-injection substance use profiles among separate urban and rural samples of Puerto Rican PWID. Material and Methods Data for the urban sample come from 455 PWID who participated in the CDC's National HIV Behavioral Surveillance survey of injection drug use in San Juan. The data for the rural sample come from 315 PWID residing in four rural cities approximately 40-miles from San Juan. Latent class analysis was used to derive separate urban and rural profiles of weekly injection and non-injection substance use. Injection behaviors were examined as possible correlates of latent class membership. Results Five latent classes were identified in the urban sample, and three latent classes were identified in the rural sample. Classes were similar across samples; however, key differences emerged. Both samples had classes of primary heroin injectors, primary speedball injectors, and cocaine-heroin injectors. The urban sample had one high polysubstance class. Polysubstance use profiles that shared similar characteristics between samples also shared similar injection patterns, with some variation. Discussion Variations in substance patterns and associated health risks are likely shaped by social and geographic boundaries. Conclusions Understanding variations in substance use patterns across rural and urban locales may improve surveillance efforts and tailor desistance and harm reduction efforts at the state and local levels.

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Injection and Sexual Behavior Profiles among People Who Inject Drugs in Miami, Florida

Chueng

Tookes

McLaughlin

et al. 2022

Substance Use & Misuse

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Latent Risk Subtypes Based on Injection and Sexual Behavior Among People Who Inject Drugs in Rural Puerto Rico

Abstract: The findings suggest ways in which PWID risk clusters can be identified for targeted interventions.

Cited by 3 publications

References 59 publications

Substance use, injection risk behaviors, and fentanyl-related overdose risk among a sample of PWID post-Hurricane Maria

Substance use, injection risk behaviors, and fentanyl-related overdose risk among a sample of PWID post-Hurricane Maria

Rural and urban comparisons of polysubstance use profiles and associated injection behaviors among people who inject drugs in Puerto Rico

Injection and Sexual Behavior Profiles among People Who Inject Drugs in Miami, Florida

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