267612 Injection of Xylazine: A contributing factor to HIV risk behaviors among Puerto Rican IV drug users

Monday, October 29, 2012

Luz M. Lopez, PhD, MPH, LCSW , School of Social Work, Boston University, Boston, MA
Abigail Ross, MSW, MPH , School of Social Work, Boston University, Boston, MA
Marcia Williams, MSW , School of Social Work & School of Education, Boston University, Boston, MA
Meghan Coyle, JD , School of Social Work, Boston University, Boston, MA
Deborah Chassler, MSW , Center for Addictions Research and Services, Boston University School of Social Work, Boston, MA
Lena Lundgren, PhD , School of Social Work, Boston University, Boston, MA
Background: Recent studies of injection drug users (IDUs) in Puerto Rico indicate widespread use of xylazine (horse anesthesia) mixed with heroin and cocaine. This study describes use of xylazine/mix and HIV risk behaviors. Methods: Data from 374 Puerto Rican IDUs was gathered through Spanish in-person interviews. Bi-variate and multivariable analyses were conducted to explore the association between xylazine use and HIV risk behaviors (sharing drug-paraphernalia, unprotected sex, sex work, injecting others) controlling for demographic characteristics, health care utilization; housing status, substance use history; and mental health symptoms. Results: On average, participants began using heroin and cocaine mixed with xylazine at age 31, whereas use of the same drugs without xylazine began between ages 18-21. Incidence of xylazine/mix injection in the sample was high (69.3%). At first use, participants who injected xylazine/mix knew it was not pure heroin because they felt a different high (76%) or had developed severe abscesses (28%). Bivariate analysis identified that xylazine/mix use was significantly associated with sharing drug-paraphernalia, unprotected sex, and injecting others. Logistic regression analysis, with all variables significant at the bivariate level, indicate that xylazine/mix use was significantly associated with higher numbers of unprotected sexual contacts in the last 30 days, controlling for age, gender, number of sexual contacts and homelessness (p≤.05). Conclusions: Future HIV prevention efforts in Puerto Rico must address xylazine/mix use and its association with HIV risk behaviors. The migratory pattern of Puerto Ricans IDUs traveling to and from the USA mainland, possibly carrying xylazine, raises additional public health concerns.

Learning Areas:
Public health or related research

Learning Objectives:
1.Participants will identify patterns of drug use, mixing xylazine (horse anesthesia) with heroin and cocaine, and its frequency of use in Puerto Rican injecting drug users. 2.Participants will evaluate the serious public health concerns of xylazine use and its risk for HIV infection.

Keywords: HIV Risk Behavior, Latinos

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Principal Investigator for this study and I have more than 18 years working in the field of HIV and substance abuse prevention with Latinos and other diverse populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.