Biculturality and HIV risk among Puerto Rican drug users in NYC

Background: Biculturalism refers to two independent processes of acculturation, one to the host society's culture and another to the culture of origin. The relationship between biculturalism and HIV risk behaviors was examined in a sample of Puerto Rican drug users (PRDUs). Methods: 261 PRDUs were recruited in NYC in 2005-2006. Biculturalism was measured by two scales: involvement in (i) American culture (AMBIC) and (ii) Puerto Rican culture (PRBIC). The HIV risk behaviors (prior 30 days) included injection drug use and having unprotected sex. Other variables examined were: socio-demographics, norms and self-efficacy regarding HIV risk. Results: 78% males; mean age 42; 53% born in PR; lived 26 years (mean) in the US; 42% currently injected drugs; and 72% enrolled in methadone treatment. AMBIC and PRBIC were not significantly related (r=-.07). AMBIC was significantly (p<.05) associated with age (older), gender (female), years living in the US, and negatively related to spending adolescence in PR, injection drug use, injection frequency, and heroin/cocaine use. PRBIC was significantly related to being born in PR, fewer years living in the US, spending adolescence in PR, and riskier norms for sex. In multiple logistic regression analysis, AMBIC remained as a significant factor in predicting lower injection risk, and PRBIC was a significant factor for higher sex risk. Conclusion/Discussion: Acculturation to the host culture and culture of origin differed in their relationship to risk, indicating that incorporating assessments of biculturality may be useful in assessing and addressing HIV risk behaviors.