Differences in HIV risk behaviors and health status between Puerto Rican injection drug users residing on the Island and the United States mainland

This study examines age of first injection drug use and its associations with HIV/AIDS, Hepatitis C, and psychiatric symptoms between two samples of Puerto Rican injection drug users (IDUs); one group residing on the Island and one residing in Massachusetts. A cross-sectional study design was used and in-person interviews were administered to 149 Puerto Ricans residing on the Island and 343 Puerto Ricans residing in Massachusetts. Bivariate analysis indicated that those on the Island started injecting drugs at an earlier age (20.8 years) than the Massachusetts sample (22.2 years old). Also, at the bi-variate level, residing on the Island was significantly associated with having an STI and with a higher likelihood of having attempted suicide. In contrast, residing in Massachusetts was significantly associated with having Hepatitis C. The logistic regression analysis which examined relationships between Island/mainland residence and HIV status controlling for age, age of first injecting, gender, and depression identified that (1) residing in US was significantly and negatively associated with HIV status. Participants in US were about 65% less likely to be HIV positive compared to their counterparts; (2) Age of first injection was significantly and negatively associated with HIV status. Participants who were older at age of first injection were 6.1% less likely to be HIV positive. Culturally specific interventions are needed to reduce drug use among Puerto-Ricans in different political and geographic regions. Research is needed to explore differences in HIV, STI and Hepatitis C rates between Puerto Ricans on the Island and the mainland.