ArticleThe International journal on drug policy2017
Differential access to syringe exchange and other prevention activities among people who inject drugs in rural and urban areas of Puerto Rico.
Article in The International journal on drug policy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 19 citations in OpenAlex.
- Preferences for harm reduction vending machine design among rural people who use drugs.Drug and alcohol dependence reports · 2025Article
- Racialized environments and syringe services program implementation: County-level factors.Drug and alcohol dependence · 2024Article
- Potential impact of curative and preventive interventions toward hepatitis C elimination in people who inject drugs-A network modeling study.The International journal on drug policy · 2024Article
- "Caballo": risk environments, drug sharing and the emergence of a hepatitis C virus epidemic among people who inject drugs in Puerto Rico.Harm reduction journal · 2020Article
- Motivation to Change and Treatment Participation Among Syringe Service Program Utilizers in Rural Kentucky.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2020Article
- Latent Risk Subtypes Based on Injection and Sexual Behavior Among People Who Inject Drugs in Rural Puerto Rico.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2018Article
- "It Ruined My Life": The effects of the War on Drugs on people who inject drugs (PWID) in rural Puerto Rico.The International journal on drug policy · 2018Article
- Rural and urban comparisons of polysubstance use profiles and associated injection behaviors among people who inject drugs in Puerto Rico.Drug and alcohol dependence · 2017Article
- Needle acquisition patterns, network risk and social capital among rural PWID in Puerto Rico.Harm reduction journal · 2017Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundInjection drug use and its associated blood-borne infections has become a rapidly increasing problem in rural areas of the US recently. Syringe exchange programs have been shown to be effective for reducing transmission of blood borne infections, however access to these prevention efforts may be limited in rural areas.
methodsThis paper utilizes two separate community samples of people who inject drugs (PWID) in Puerto Rico to achieve the following research objectives: (1) compare rural and urban access to syringe exchange programs, free sterile syringes and other HIV/HCV prevention activities, and (2) examine whether utilization of prevention activities is associated with lower injection risk behaviors. Two samples were recruited with RDS (n=315 rural sample; n=512 urban sample) and included adults aged 18 years and older who have injected drugs within the past month.
results78.5% of the urban sample utilized a syringe exchange program in the past year, compared to 58.4% of the rural sample (p<.001). 71.4% of the urban sample received free sterile needles, compared to 58.4% of the rural sample (p<.001). 66% of the urban sample received free works compared to 59% of the rural sample (p=.034). 29% of urban PWID had a conversation with an outreach worker about HIV prevention compared to 18% of the rural sample (p<0.001). Receiving free needles significantly increases the frequency of using a sterile needle to inject (p<.001).
conclusionUrban PWID were significantly more likely to have utilized syringe exchange programs, received free sterile needles, received free works, and to have talked about HIV prevention with an outreach worker during the past year than PWID residing in rural areas. Individuals who accessed these prevention activities were significantly less likely to exhibit risky injection behavior. Policy implications call for increasing access to prevention services in rural areas to reduce disease transmission.
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