Differential access to syringe exchange and other prevention activities among people who inject drugs in rural and urban areas of Puerto Rico

Melissa Welch-Lazoritz, Patrick Habecker, Kirk Dombrowski, Angelica Rivera Villegas, Carmen Ana Davila, Yadira Rolón Colón, Sandra Miranda De León

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Injection drug use and its associated blood-borne infections has become a rapidly increasing problem in rural areas of the US recently. Syringe exchange programs have been shown to be effective for reducing transmission of blood borne infections, however access to these prevention efforts may be limited in rural areas. Methods This paper utilizes two separate community samples of people who inject drugs (PWID) in Puerto Rico to achieve the following research objectives: (1) compare rural and urban access to syringe exchange programs, free sterile syringes and other HIV/HCV prevention activities, and (2) examine whether utilization of prevention activities is associated with lower injection risk behaviors. Two samples were recruited with RDS (n = 315 rural sample; n = 512 urban sample) and included adults aged 18 years and older who have injected drugs within the past month. Results 78.5% of the urban sample utilized a syringe exchange program in the past year, compared to 58.4% of the rural sample (p < .001). 71.4% of the urban sample received free sterile needles, compared to 58.4% of the rural sample (p < .001). 66% of the urban sample received free works compared to 59% of the rural sample (p = .034). 29% of urban PWID had a conversation with an outreach worker about HIV prevention compared to 18% of the rural sample (p < 0.001). Receiving free needles significantly increases the frequency of using a sterile needle to inject (p < .001). Conclusion Urban PWID were significantly more likely to have utilized syringe exchange programs, received free sterile needles, received free works, and to have talked about HIV prevention with an outreach worker during the past year than PWID residing in rural areas. Individuals who accessed these prevention activities were significantly less likely to exhibit risky injection behavior. Policy implications call for increasing access to prevention services in rural areas to reduce disease transmission.

Original languageEnglish (US)
Pages (from-to)16-22
Number of pages7
JournalInternational Journal of Drug Policy
Volume43
DOIs
StatePublished - May 1 2017

Fingerprint

Puerto Rico
Syringes
Needle-Exchange Programs
Needles
Pharmaceutical Preparations
HIV
Injections
Risk-Taking
Infection
Research

Keywords

  • HIV
  • Hepatitis C
  • Injection drug use
  • Syringe exchange programs

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health Policy

Cite this

Differential access to syringe exchange and other prevention activities among people who inject drugs in rural and urban areas of Puerto Rico. / Welch-Lazoritz, Melissa; Habecker, Patrick; Dombrowski, Kirk; Rivera Villegas, Angelica; Davila, Carmen Ana; Rolón Colón, Yadira; Miranda De León, Sandra.

In: International Journal of Drug Policy, Vol. 43, 01.05.2017, p. 16-22.

Research output: Contribution to journalArticle

Welch-Lazoritz, Melissa ; Habecker, Patrick ; Dombrowski, Kirk ; Rivera Villegas, Angelica ; Davila, Carmen Ana ; Rolón Colón, Yadira ; Miranda De León, Sandra. / Differential access to syringe exchange and other prevention activities among people who inject drugs in rural and urban areas of Puerto Rico. In: International Journal of Drug Policy. 2017 ; Vol. 43. pp. 16-22.
@article{6198962022b94eff975c1849f35a2ea6,
title = "Differential access to syringe exchange and other prevention activities among people who inject drugs in rural and urban areas of Puerto Rico",
abstract = "Background Injection drug use and its associated blood-borne infections has become a rapidly increasing problem in rural areas of the US recently. Syringe exchange programs have been shown to be effective for reducing transmission of blood borne infections, however access to these prevention efforts may be limited in rural areas. Methods This paper utilizes two separate community samples of people who inject drugs (PWID) in Puerto Rico to achieve the following research objectives: (1) compare rural and urban access to syringe exchange programs, free sterile syringes and other HIV/HCV prevention activities, and (2) examine whether utilization of prevention activities is associated with lower injection risk behaviors. Two samples were recruited with RDS (n = 315 rural sample; n = 512 urban sample) and included adults aged 18 years and older who have injected drugs within the past month. Results 78.5{\%} of the urban sample utilized a syringe exchange program in the past year, compared to 58.4{\%} of the rural sample (p < .001). 71.4{\%} of the urban sample received free sterile needles, compared to 58.4{\%} of the rural sample (p < .001). 66{\%} of the urban sample received free works compared to 59{\%} of the rural sample (p = .034). 29{\%} of urban PWID had a conversation with an outreach worker about HIV prevention compared to 18{\%} of the rural sample (p < 0.001). Receiving free needles significantly increases the frequency of using a sterile needle to inject (p < .001). Conclusion Urban PWID were significantly more likely to have utilized syringe exchange programs, received free sterile needles, received free works, and to have talked about HIV prevention with an outreach worker during the past year than PWID residing in rural areas. Individuals who accessed these prevention activities were significantly less likely to exhibit risky injection behavior. Policy implications call for increasing access to prevention services in rural areas to reduce disease transmission.",
keywords = "HIV, Hepatitis C, Injection drug use, Syringe exchange programs",
author = "Melissa Welch-Lazoritz and Patrick Habecker and Kirk Dombrowski and {Rivera Villegas}, Angelica and Davila, {Carmen Ana} and {Rol{\'o}n Col{\'o}n}, Yadira and {Miranda De Le{\'o}n}, Sandra",
year = "2017",
month = "5",
day = "1",
doi = "10.1016/j.drugpo.2016.12.011",
language = "English (US)",
volume = "43",
pages = "16--22",
journal = "International Journal of Drug Policy",
issn = "0955-3959",
publisher = "Elsevier",

}

TY - JOUR

T1 - Differential access to syringe exchange and other prevention activities among people who inject drugs in rural and urban areas of Puerto Rico

AU - Welch-Lazoritz, Melissa

AU - Habecker, Patrick

AU - Dombrowski, Kirk

AU - Rivera Villegas, Angelica

AU - Davila, Carmen Ana

AU - Rolón Colón, Yadira

AU - Miranda De León, Sandra

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background Injection drug use and its associated blood-borne infections has become a rapidly increasing problem in rural areas of the US recently. Syringe exchange programs have been shown to be effective for reducing transmission of blood borne infections, however access to these prevention efforts may be limited in rural areas. Methods This paper utilizes two separate community samples of people who inject drugs (PWID) in Puerto Rico to achieve the following research objectives: (1) compare rural and urban access to syringe exchange programs, free sterile syringes and other HIV/HCV prevention activities, and (2) examine whether utilization of prevention activities is associated with lower injection risk behaviors. Two samples were recruited with RDS (n = 315 rural sample; n = 512 urban sample) and included adults aged 18 years and older who have injected drugs within the past month. Results 78.5% of the urban sample utilized a syringe exchange program in the past year, compared to 58.4% of the rural sample (p < .001). 71.4% of the urban sample received free sterile needles, compared to 58.4% of the rural sample (p < .001). 66% of the urban sample received free works compared to 59% of the rural sample (p = .034). 29% of urban PWID had a conversation with an outreach worker about HIV prevention compared to 18% of the rural sample (p < 0.001). Receiving free needles significantly increases the frequency of using a sterile needle to inject (p < .001). Conclusion Urban PWID were significantly more likely to have utilized syringe exchange programs, received free sterile needles, received free works, and to have talked about HIV prevention with an outreach worker during the past year than PWID residing in rural areas. Individuals who accessed these prevention activities were significantly less likely to exhibit risky injection behavior. Policy implications call for increasing access to prevention services in rural areas to reduce disease transmission.

AB - Background Injection drug use and its associated blood-borne infections has become a rapidly increasing problem in rural areas of the US recently. Syringe exchange programs have been shown to be effective for reducing transmission of blood borne infections, however access to these prevention efforts may be limited in rural areas. Methods This paper utilizes two separate community samples of people who inject drugs (PWID) in Puerto Rico to achieve the following research objectives: (1) compare rural and urban access to syringe exchange programs, free sterile syringes and other HIV/HCV prevention activities, and (2) examine whether utilization of prevention activities is associated with lower injection risk behaviors. Two samples were recruited with RDS (n = 315 rural sample; n = 512 urban sample) and included adults aged 18 years and older who have injected drugs within the past month. Results 78.5% of the urban sample utilized a syringe exchange program in the past year, compared to 58.4% of the rural sample (p < .001). 71.4% of the urban sample received free sterile needles, compared to 58.4% of the rural sample (p < .001). 66% of the urban sample received free works compared to 59% of the rural sample (p = .034). 29% of urban PWID had a conversation with an outreach worker about HIV prevention compared to 18% of the rural sample (p < 0.001). Receiving free needles significantly increases the frequency of using a sterile needle to inject (p < .001). Conclusion Urban PWID were significantly more likely to have utilized syringe exchange programs, received free sterile needles, received free works, and to have talked about HIV prevention with an outreach worker during the past year than PWID residing in rural areas. Individuals who accessed these prevention activities were significantly less likely to exhibit risky injection behavior. Policy implications call for increasing access to prevention services in rural areas to reduce disease transmission.

KW - HIV

KW - Hepatitis C

KW - Injection drug use

KW - Syringe exchange programs

UR - http://www.scopus.com/inward/record.url?scp=85011298670&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85011298670&partnerID=8YFLogxK

U2 - 10.1016/j.drugpo.2016.12.011

DO - 10.1016/j.drugpo.2016.12.011

M3 - Article

C2 - 28160735

AN - SCOPUS:85011298670

VL - 43

SP - 16

EP - 22

JO - International Journal of Drug Policy

JF - International Journal of Drug Policy

SN - 0955-3959

ER -