Comorbidity and HIV Risk Behaviors among Hispanic Drug Users Residing in Puerto Rico

1. Comorbidity and HIV Risk Behaviors among Hispanic Drug Users Residing in Puerto Rico Oral Presentation Session XV 6/19/2003

2. Introduction Puerto Rico has been one of the HIV epicenters of the United States since the middle 1980s, soon after the Island�s first AIDS case was detected in 1981 Puerto Rico ranks fourth in AIDS incidence after Washington, D.C., New York, and Maryland Early in the initial period of the HIV epidemic in Puerto Rico, drug users were identified as the group at highest risk of HIV transmission

3. Introduction In contrast to the U.S. population, injection drug use has been found to be the most common risk factor for AIDS in Puerto Rico and among Puerto Ricans in the US mainland HIV seroprevalence rates for IDUs in Puerto Rico appear to have followed a downward trend similar to those observed among IDUs in several northeastern U.S. cities

4. Introduction Although AIDS incidence has decreased in the Island, our recent studies continue to show a significantly high prevalence of HIV risk behaviors, especially among young drug injectors In Puerto Rico, as in the U.S., many preventive programs have been conducted since the late 1980s to reduce HIV risk behaviors among drug injectors

5. Introduction Previous reports have shown significant associations between mental health conditions and HIV risk behaviors among drug users This study will add to previous studies by providing data specifically related to depression and anxiety and their association with HIV risk behaviors, among Hispanic drug injectors recruited in the Island�s neighborhoods

6. Methods Recruitment Area North region of Puerto Rico Eligibility Criteria Had injected in the last 30 days prior to the interview At least 18 yrs. Old Were not enrolled in drug abuse treatment during the last 30 days prior to the interview

7. Methods Sample 557 injection drug users Instrument Socio demographics Drug use patterns HIV risk behaviors Beck inventory scale for anxiety and depression symptoms Analysis Frequency distributions Chi-square test of independence Logistic regression

8. Description of the study sample Table 1 compares the experimental group and control group in demographic characteristics. This table shows that the only difference between the two groups was previous drug treatment. Drug users in the control group were more likely to have been in treatment than their peers in the experimental group. When comparing the demographic characteristics for the control and experimental groups, the only significant difference between them was that, drug users in the control group were more likely to have been in drug treatment than their peers in the experimental group. Table 1 compares the experimental group and control group in demographic characteristics. This table shows that the only difference between the two groups was previous drug treatment. Drug users in the control group were more likely to have been in treatment than their peers in the experimental group. When comparing the demographic characteristics for the control and experimental groups, the only significant difference between them was that, drug users in the control group were more likely to have been in drug treatment than their peers in the experimental group.

9. Drug Use and Mental Health Co-morbidity by Socio-demographics drug use Patterns and other Health Related Variables

10. Drug Use and Mental Health Co-morbidity by Socio-demographics drug use Patterns and other Health Related Variables

11. Logistic Regression Analyses

12. Discussion Data from this study concur with previous studies showing that comorbidity involving various psychiatric conditions has been related to HIV risk behaviors This study shows that among Islander Puerto Rican drug injectors not-in-treatment, those affected by either high depression symptomatology or anxiety are significantly more likely to share needles, cotton, or rinse water, and engage in back loading

13. Discussion The results from this study of heroin injectors with depression or anxiety suggest that these individuals are clearly in need of special attention The development of interventions tailored to address heroin injection, depression, and anxiety seems necessary in order to reduce HIV risks and to decrease drug injection