Estimates of the Population Prevalence of Injection Drug Users among Hispanic Residents of Large US Metropolitan Areas

Abstract

Little information exists on the population prevalence or geographic distribution of injection drug users (IDUs) who are Hispanic in the USA. Here, we present yearly estimates of IDU population prevalence among Hispanic residents of the 96 most populated US metropolitan statistical areas (MSAs) for 1992-2002. First, yearly estimates of the proportion of IDUs who were Hispanic in each MSA were created by combining data on (1) IDUs receiving drug treatment services in Substance Abuse and Mental Health Services Administration (SAMHSA)'s Treatment Entry Data System, (2) IDUs being tested in the Centers for Disease Control and Prevention (CDC) HIV-Counseling and Testing System, and (3) incident AIDS diagnoses among IDUs, supplemented by (4) data on IDUs who were living with AIDS. Then, the resulting proportions were multiplied by published yearly estimates of the number of IDUs of all racial/ethnic groups in each MSA to produce Hispanic IDU population estimates. These were divided by Hispanic population data to produce population prevalence rates. Time trends were tested using mixed-effects regression models. Hispanic IDU prevalence declined significantly on average (1992 mean=192, median=133; 2002 mean=144, median=93; units are per 10,000 Hispanics aged 15-64). The highest prevalence rates across time tended to be in smaller northeastern MSAs. Comparing the last three study years to the first three, prevalence decreased in 82% of MSAs and increased in 18%. Comparisons with data on drug-related mortality and hepatitis C mortality supported the validity of the estimates. Generally, estimates of Hispanic IDU population prevalence were higher than published estimates for non-Hispanic White residents and lower than published estimates for non-Hispanic Black residents. Hispanics infected with HIV are twice as likely as non-Hispanic Whites to be diagnosed late in the course of their infection.3 Hispanic IDUs may be less likely to utilize HIV prevention services, or services for drug users, than non-Hispanics due to greater concern about stigma regarding drug use, HIV/AIDS, or the association between HIV/AIDS and homosexuality. [4][5][6][7] Research on Hispanic IDUs is hampered by the lack of information on their number and geographic location over time. Such information could be used to better target HIV and hepatitis C prevention programs among Hispanic IDUs and to compare trends in injection drug use, HIV, and hepatitis C across racial/ethnic groups. Data on overall IDU prevalence and on IDU prevalence among nonHispanic White and non-Hispanic Black residents aged 15-64 of the 96 largest US metropolitan statistical areas (MSAs) have been published for the 1992-2002 period.8,9The current study fills a crucial gap by providing estimates of IDU population prevalence among Hispanic residents aged 15-64 in the same set of MSAs during the same time period. To extend the analysis to more recent years, we also examine change in the estimated proportion of IDUs who were Hispanic from 2002 to 2007. METHODSWe use the term ...

Time Since Migration and HIV Risk Behaviors Among Puerto Ricans Who Inject Drugs in New York City

“…To unfold, enculturation requires a cultural enclave. There is a sizeable Puerto Rican PWID population in the Northeast (CDC, 2010; Pouget et al, 2012), and in NYC, the presence of Spanish-monolingual immigrant Puerto Rican PWID is documented (Gelpí-Acosta et al, 2011; Neaigus et al, 2013). A qualitative study found a risk-prone “Puerto Rican-way of injecting drugs” that endorses syringe sharing among “brothers,” (immigrant-only) perpetuating their injection risks in NYC (Gelpí-Acosta et al, 2011).…”

Trends in the Population Prevalence of People Who Inject Drugs in US Metropolitan Areas 1992–2007

“…PWID prevalence for non-Hispanic white adults remained relatively flat over time (median values ranged between 86 and 97 injectors per 10,000 adults). Hispanic PWID prevalence rate also declined significantly (1992 mean = 192, median = 133; 2002 mean = 144, median = 93) [45].…”

Income inequality, drug-related arrests, and the health of people who inject drugs: Reflections on seventeen years of research

“…[See these selected papers that describe trends in PWID or in HIV among PWID (Chatterjee et al, 2011; Cooper et al, 2008; Pouget, Friedman, Cleland, Tempalski, & Cooper, 2012; Tempalski et al, 2009, 2013; West et al, 2016); in services for PWID (Tempalski, Cleland, Chatterjee, Pouget, & Friedman, 2010); and predictors of service presence or coverage (Friedman et al, 2007; Tempalski et al, 2003, 2007, 2008). ] Instead, we briefly and selectively summarize some key findings from five of these papers that directly addressed the predictors of PWID population prevalence or HIV prevalence or incidence at the metropolitan level, and then discuss some implications of these findings.…”