Abstract
In the process of preparing jointly purchased drugs, injection drug users (IDUs) may share drug preparation materials and use a single syringe to distribute injectable drugs. The aim of this study was to examine the association of joint drug purchasing with drug preparation risk behaviors among Puerto Rican IDUs. The study sample comprised 555 IDUs from New York City and 297 from Puerto Rico. IDUs reported pooling money for 12% of the injection episodes in New York, and for 14% of the injection episodes in Puerto Rico. In both study sites, all correlation coefficients between frequency of pooling money and drug preparation behaviors were .30 or larger. After controlling for sociodemographics, drugs injected, and injection frequency, pooling money was significantly associated to all four drug preparation behaviors in both study sites. HIV prevention interventions need to be cognizant of the joint purchasing of drugs and its relationship to drug preparation risk behaviors.
Similar content being viewed by others
REFERENCES
Burrows, D. (1998). Injecting equipment provision inAustralia: The state of play. Substance Use and Misuse, 33, 1113–1127.
Carlson, R. G., Siegal, H. A., and Falck, R. S. (1994). Ethnography, epidemiology, and public policy: Needle-use practices and HIV-1 risk reduction among injecting drug users in the Midwest. In D. A. Feldman (Ed.), Global AIDS policy (pp. 183–214). Westport, CT: Bergin and Garvey.
Carlson, R. G., Siegal, H. A., Wang, J., and Falck, R. S. (1996). Attitudes toward needle “sharing” among injection drug users: Combining qualitative and quantitative research methods. Human Organization, 55, 361–369.
Centers for Disease Control and Prevention. (1999). U.S. HIV and AIDS cases reported through June 1999. HIV/AIDS Surveillance Report, 11, 6–8.
Clatts,M. (1999, April). Integrating ethnography and virology in the study of transmission of blood-borne pathogens among IDUs. Paper presented at the annual meeting of the Society for Applied Anthropology, Tucson, AZ.
Deren, S., Davis, W. R., Beardsley, M., Tortu, S., and Clatts, M. (1995). Outcomes of a risk reduction intervention with high risk populations: The Harlem AIDS Project. AIDS Education and Prevention, 7, 379–390.
Diaz, T., Buehler, J. W., Castro. K. G., and Ward, J. W. (1993). AIDS trends among Hispanics in the United States. American Journal of Public Health, 83, 504–509.
Dowling, G. S., Johnson, M. E., Fisher, D. G., and Needle, R. (1994). Reliability of drug users' self-reported HIV risk behaviors and validity of self-reported recent drug use. Assessment, 1, 383–392.
Finlinson, H. A., Oliver-Vélez,D., Colón, H. M., Deren, S., Robles, R. R., Beardsley, M., Cant, J.G. H., Andía, J., and Soto-López, M. (in press). Syringe acquisition and use of syringe exchange programs by Puerto Rican drug injectors in New York and Puerto Rico: Comparisons based on quantitative and qualitative methods. AIDS and Behavior.
Grund, J. P., Kaplan, C. D., Adriaans, N. F., and Blanken, P. (1991). Drug sharing and HIV transmission risks: The practice of frontloading in the Dutch injecting drug user population. Journal of Psychoactive Drugs, 23, 1–10.
Guydish, J., Bucardo, J., Clark, G., and Bernheim, S. (1998). Evaluating needle exchange: A description of client characteristics, health status, program utilization, and HIV risk behavior. Substance Use & Misuse, 33, 1173–1196.
Hagan, H., McGoughm, J. P., Thiede, H., Weiss, N. S., Hopkins, S., and Alexander, E. R. (1999). Syringe exchange and risk of infection with Hepatitis B and C viruses. American Journal of Epidemiology, 149, 203–213.
Hankins, C. A. (1998). Syringe exchange in Canada: Good but not enough to stem the HIV tide. Substance Use & Misuse, 33, 1129–1146.
Inciardi, J. A., and Page, J. B. (1991). Drug sharing among intravenous drug users. AIDS, 5, 772–773.
Jose, B., Friedman, S. R., Neaigus, A., Curtis, R., Grund, J. P., Goldstein, M. F., Ward, T. P., and Des Jarlais, D. C. (1993). Syringe-mediated drug-sharing (backloading):Anew risk factor for HIV among injecting drug users. AIDS, 7, 1653–1660.
Koester, S., Booth, R., and Wiebel, W. (1990). The risk of HIV transmission from sharing water, drug-mixing containers and cotton filters among intravenous drug users. International Journal of Drug Policy, 1, 28–30.
Koester, S., Booth, R. E., and Zhang, Y. (1996). The prevalence of additional injection-related HIV risk behaviors among injection drug users. Journal of Acquired Immune Deficiency Syndromes & Human Retrovirology, 12, 202–207.
Koester, S., Clement-Johnson, A., and Sosa, C. (1999, April). Ethnography as praxis: The evolution of a socially focused intervention model. Paper presented at the annual meeting of the Society for Applied Anthropology, Tucson, AZ.
Koester, S., and Hoffer, L. (1994). “Indirect sharing”: Additional HIV risks associated with drug injection. AIDS & Public Policy Journal, 9, 100–105.
Koester, S. (1996). The process of drug injection: Applying ethnography to the study of HIV risk among IDUs. In T. Rhodes, and R. Harmoll (Eds.), AIDS, drugs, and prevention: Perspectives on individual and community action (pp. 133–148). London: Routledge.
McCoy, C. B., Metsch, L., Shapshak, P., Weatherby, N., Lai, S., Comerford, S., and Needle, R. (1996, July). Interdisciplinary studies of risky practices as potential sources for the secondary transmission of HIV-1 among injecting drug users: Beyond needles and syringes. Paper presented at the XI International Conference on AIDS, Vancouver, Canada.
Montoya, I. D., Bell, D. C., Richard, A. J., Carlson, J. W., and Trevino, R. A. (1999). Estimated HIV risk among Hispanics in a national sample of drug users. Journal of Acquired Immune Deficiency Syndromes, 21, 21–50.
Needle, R. H., Coyle, S., Cessari, H., Trotter, R., Clatts, M., Koester, S., Price, L., McLellan, E., Finlinson, A., Bluthenthal, R., Pierce, T., Johnson, J., Jones, S., and Williams, M. (1998). HIV risk behaviors associated with the injection process: Multiperson use of drug injection equipment and paraphernalia in IDU networks. Substance Use and Misuse, 33, 2403–2423.
Oliver-Vélez,D., Finlinson, H. A., Deren, S., Robles,R. R., Shedlin, M., Andía, J., and Colón, H. M. (in press). Mapping the air bridge: The application of ethnographic mapping techniques to a dual-site study of HIV risk behavior determinants in East Harlem, New York, and Bayamón, Puerto Rico. Human Organization.
Page, J.B. (1990). Intravenous drug use and HIV infection in Miami. Medical Anthropology Quarterly, 4, 56–71.
Paone, D., Des Jarlais, D. C., Gangloff, R., Milliken, J., and Friedman, S. R. (1995). Syringe exchange: HIV prevention, key findings, and future directions. International Journal of the Addictions, 30, 1647–1683.
Puerto Rico Department of Health. (1999). Puerto Rico AIDS surveillance report. San Juan: Puerto Rico AIDS Surveillance System.
Robles, R. R., Colón, H. M., Dáz, N., MacGowan, R., Cancel, L. I., Cole, G. E., and Allen, D. M. (1994). Behavioural risk factors and HIV infection of injection drug users at detoxification clinics in Puerto Rico. International Journal of Epidemiology, 23, 595–601.
Robles, R. R., Colón, H. M., Matos, T. D., Finlinson, H. A., Muñoz, A., Marrero, C. A., García, M., and Reyes, J. C. (1998). Syringe and needle exchange as HIV/AIDS prevention for injection drug users in Puerto Rico. Health Policy, 45, 209–220.
Robles, R. R., Colón, H. M., Matos, T. D., Reyes, J. C., Marrero, C. A., and López, C. M. (1993). Risk factors and HIV infection among three different cultural groups of intravenous drug users. In B. S. Brown and G. M. Beschner (Eds.), Handbook on risk of AIDS: Injection drug users and sexual partners (pp. 256–274). Westport, CT: Greenwood Publishing Group, Inc.
Robles, R. R., Colón, H. M., Sahai, H., Matos, T. D., Marrero, C. A., and Reyes, J. C. (1992). Behavioral risk factors and HIV prevalence among intravenous drug users in Puerto Rico. American Journal of Epidemiology, 135, 531–540.
Samuels, J. F., Vlahov, D., Anthony, J. C., Solomon, L., and Celentano, D. D. (1991). The practice of 'frontloading' among intravenous drug users: Association with HIV-antibody. AIDS, 5, 343.
Selik, R. M., Castro, K. G., and Pappaioanou, M. (1988). Racial/ethnic differences in the risk of AIDS in the United States. American Journal of Public Health, 78, 1539–1545.
Shah, S. M., Shapshak, P., Rivers, J. E., Stewart, R. V., Weatherby, N. L., Xin, K. Q., Page, J. B., Chitwood, D. D., Mash, D. C., Vlahov, D., and McCoy, C. B. (1996). Detection of HIV-1 DNA in needle/syringes, paraphernalia, and washes from shooting galleries in Miami: A preliminary laboratory report. Journal of Acquired Immune Deficiency Syndromes & Human Retrovirology, 11, 301–306.
Stark, K., Muller, R., Bienzle, U., and Guggenmoos-Holzmann, I. (1996). Frontloading: A risk factor for HIV and hepatitis C virus infection among injecting drug users in Berlin. AIDS, 10, 311–317.
Vlahov, D., Khabbaz, R. F., Cohn, S., Galai, N., Taylor, E., and Kaplan, J. E. (1995). Incidence and risk factors for human T-lymphotropic virus Type II seroconversion among injecting drug users in Baltimore, Maryland, USA. Journal of Acquired Immunodeficiency Syndrome, 9, 89–96.
Weatherby, N. L., Needle, R., Cesari, H., and Booth, R. E. (1994). Validity of self-reported drug use among injection drug users and crack cocaine users recruited through street outreach. Evaluation and Program Planning, 17, 347–355.
Zule, W. A. (1992). Risk and reciprocity: HIV and the injection drug user. Journal of Psychoactive Drugs, 24, 243–249.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Colón, H.M., Finlinson, H.A., Robles, R.R. et al. Joint Drug Purchases and Drug Preparation Risk Behaviors Among Puerto Rican Injection Drug Users. AIDS Behav 5, 85–96 (2001). https://doi.org/10.1023/A:1009515723223
Issue Date:
DOI: https://doi.org/10.1023/A:1009515723223