ArticleThe International journal on drug policy2019
Injection risk norms and practices among migrant Puerto Rican people who inject drugs in New York City: The limits of acculturation theory.
Article in The International journal on drug policy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 19 citations in OpenAlex.
- Extreme vulnerability to overdose mortality: Intersections of detailed race/ethnicity, educational attainment, age, sex, and nativity.Drug and alcohol dependence · 2025Article
- Willingness to use fentanyl test strips among street drug users in Puerto Rico: a cross-sectional study.Harm reduction journal · 2025Article
- Prevalence and associated risk factors of hepatitis C antibody and RNA among people who inject drugs in Puerto Rico.Journal of substance use and addiction treatment · 2024Article
- Overdose deaths involving synthetic opioids: Racial/ethnic and educational disparities in the eastern and western US.Drug and alcohol dependence · 2023Article
- Hepatitis C virus care cascade among people who inject drugs in puerto rico: Minimal HCV treatment and substantial barriers to HCV care.Drug and alcohol dependence reports · 2023Article
- Article
- "I don't want to die": a qualitative study of coping strategies to prevent fentanyl-related overdose deaths among people who inject drugs and its implications for harm reduction policies.Harm reduction journal · 2023Article
- Similarities and Differences in Alcohol & Other Drug Dependence Among Hispanic/Latino Subgroups: A Disaggregation Approach.Drug and alcohol dependence reports · 2022Article
- Racial and ethnic data justice: The urgency of surveillance data disaggregation.Drug and alcohol dependence reports · 2022Article
- Risk of Drug Overdose Mortality for Island-Born and US-Born Puerto Ricans, 2013-2019.Journal of racial and ethnic health disparities · 2022Article
- Toward Community Empowerment: The Puerto RicanContemporary drug problems · 2021Article
- "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
- Puerto Rican Syndemics: Opiates, Overdoses, HIV, and the Hepatitis C Virus in a Context of Ongoing Crises.American journal of public health · 2020Article
- Network ethnic homophily and injection equipment sharing among Latinx and White non-Latinx people who inject drugs.Journal of ethnicity in substance abuseArticle
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6 authors at 4 institutions in 1 country.
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Abstract
backgroundAmong people who inject drugs (PWID) in New York City (NYC), racial minorities are disproportionately infected with HIV and hepatitis C (HCV). Prior research has shown that PWID who started injecting drugs in Puerto Rico (P.R.) tend to maintain the risky injection behaviors learned there. This study identifies the P.R.-native norms supporting the continued injection risk behavior of migrant Puerto Rican PWID in NYC to inform a culturally appropriate risk-reduction intervention.
methods40 migrant Puerto Rican PWID were recruited in NYC for a longitudinal qualitative study. The sample was stratified to include 20 migrants with <3 years in NYC and 20 migrants with >3-6 years in NYC. Time-location sampling was used to curb possible network bias in recruitment. Over 12 months, migrants completed semi-structured interviews at baseline, monthly follow-ups, and study exit. Analyses were guided by grounded theory.
resultsMost participants (90%) reported having had chronic HCV, and 22.5% reported being HIV-positive. Syringe- and cooker-/cotton-sharing were widespread in both P.R. and NYC. The ubiquitous practice of cleaning used syringes by "water-rinsing and air-blowing" was guided by a normative belief, learned in P.R., that "water and air kill HIV." Sterile syringe use was not a priority. HCV was not a concern. P.R.-native abstinence-only narratives discouraged opioid agonist treatment (OAT) enrollment among recent migrants (≤3 years). Experiences with drug dealers, prison-power groups, and injection doctors ("Gancheros") in P.R. influenced migrants' injection risk behavior in NYC. Those who were Gancheros in P.R. continued working as Gancheros in NYC.
conclusionsInjection risks make migrant Puerto Rican PWID in NYC vulnerable to HIV/HCV. Harm reduction programs should pay closer attention to the rationales behind these injection risks. A risk-reduction intervention that incorporates the Ganchero figure may be a credible way to help migrants reduce injection risk and accept OAT and syringe exchange programs (SEP).
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