HIV prevention service encounters and changes in needle sharing activity among Latino injection drug users: The case of La Voz (The Voice)

Existing HIV prevention research suggests that specific types of HIV prevention and outreach services are associated with reduced needle-sharing activity among injection drug users (IDUs). This study expands on this research by conducting a detailed examination of all HIV prevention services received by a sample of 223 Latino IDUs who shared needles/“works” at base-line. Through regression modeling, the study explored the relationship between the total number of HIV prevention service encounters received and changes in needle-sharing activity over a six-month time period. Services were delivered at La Voz, a Massachusetts, community-based HIV/AIDS prevention, education, and treatment program serving Latinos, many of whom migrated to the U.S. from Puerto Rico.

Statistical analysis was conducted controlling for factors known to be significantly associated with needle sharing including, age, gender, ethnicity, criminal justice involvement, HIV status, prescribed medications for mental health symptoms, and days used illegal drugs in the past 30 days. Logistic regression analysis indicated that IDUs with more than seven encounters (the mean) were 51% less likely to share needles and/or “works” at 6-month follow-up than those who received seven or fewer encounters (p<.05). The study also identified that being prescribed psychiatric medications and having committed a crime in the past 30 days were significantly associated with still sharing needles at follow-up.

Given these findings, public health policymakers should consider targeting resources to more comprehensive HIV-prevention efforts with IDUs. Also, HIV prevention and outreach efforts need to expand to better serve IDUs with co-morbid psychiatric problems and criminal justice involvement.