RESIDENTIAL STATUS AND HIV RISK BEHAVIORS AMONG PUERTO RICAN DRUG INJECTORS IN NEW YORK AND PUERTO RICO^*

Abstract

This article investigates the association between residential status and human immunodeficiency virus (HIV) risk behaviors among island and New York Puerto Rican injection drug users (IDUs). We assigned 561 subjects from New York City and 312 from Puerto Rico to five residential status categories: living in parent's home, living in own home, living in other's home, living in temporary housing (hotel, single-room occupancy [SRO] hotels), and homeless (living in streets/shelters). Dependent variables included injection- and sex-related risk behaviors (sharing syringes, sharing other injection paraphernalia, shooting gallery use, and having paid sex). Chi square, t tests, and multivariate logistic analysis tests were performed separately by site. About one-quarter of the sample in each site was homeless. Island Puerto Ricans were more likely to live with their parents (44% vs. 12%, p < .001), and more New York IDUs lived in their own home (30% vs. 14%, p < .001). In New York, gallery use and paid sex were associated with living in other's home, living in parent's home, and being homeless. Sharing paraphernalia was related to living in other's home, living in temporary housing, and being homeless. In Puerto Rico, having paid sex was associated with homelessness. High-risk behaviors were more likely among homeless IDUs in both sites. Programs to provide housing and target outreach and other prevention programs for homeless IDUs would be helpful in reducing HIV risk.

Housing Instability among People Who Inject Drugs: Results from the Australian Needle and Syringe Program Survey

“…This lack of association may be accounted for by the challenges inherent in attempting to relate current or recent risks to prevalent outcomes. Relationships between current housing and recent injecting risk behaviors were more consistent, and fit with an extensive literature demonstrating associations between housing and a range of injection risk behaviors, 48,53,65,84,85 although it is notable that specific relationships have varied across studies. In our study, unstably housed participants were significantly more likely than their stably housed counterparts to report both recent public injecting and recent receptive sharing of injecting equipment other than syringes.…”

“…In our study, unstably housed participants were significantly more likely than their stably housed counterparts to report both recent public injecting and recent receptive sharing of injecting equipment other than syringes. Andia et al 84 likewise demonstrated that among Puerto Rican PWID homelessness was not associated with sharing syringes, but was associated with sharing other injecting equipment. Our results are consistent with previous research demonstrating that homeless PWID are more likely to inject in public spaces 43 ; and that public injecting is associated with frequent and hasty injecting and the sharing of injecting equipment.…”

Homelessness and HIV Risk Behaviors among Injection Drug Users

“…The final measure was whether the study participant engaged in sex that involved the exchange of money. As reported in the work of Andia et al, 16 the first two measures have been widely identified as HIV transmission routes and the last two as circumstances in which behavior is likely to occur that enables HIV transmission.…”

“…This study was similar in key respects to those of Andia et al 16 and Song et al 18 in that it used the advantages of longitudinal data to examine the relationship between different housing statuses and specific HIV risk behaviors. This study, however, treated both housing status and risk behaviors as phenomena with occurrences that vary not only across IDUs, but also among individual IDUs over time.…”

“…Andia et al, 16 examining risk behaviors associated with residential status among Puerto Rican IDUs in Puerto Rico and New York City, classified five different types of residential status: homelessness, living with parents, living with others, living in temporary housing such as a hotel, and living in one's own home. Such a taxonomy enables the comparison of homelessness with stable housing (rather than all other types of housing); maintains homelessness as a discrete category; and allows for the possibility that dynamics associated with other types of housing may also have an impact on risk behaviors.…”