Homelessness and HIV Risk Behaviors Among Drug Injectors in Puerto Rico

The current report examined the association between homelessness and HIV risk behaviors among injection drug users (IDUs). Subjects were recruited from inner-city neighborhoods of the North Metro Health Care Region in Puerto Rico.

Five-hundred fifty-seven study subjects who were not in treatment were categorized into three groups by residential status (last 30 days): housed, transitionally housed (living with family, friends or others but considering themselves homeless), and on-the-street homeless (living in a shelter or on the street). Transitionally housed and on-the-street homeless comprised 16 percent of the total sample.

Using multiple logistic regression models and adjusting for sociodemographic and drug-use related covariates, the authors assessed the effects of residential status on each HIV risk behavior. The researchers found that on-the-street homeless IDUs were more likely to test HIV-positive than were transitionally housed and housed IDUs. Adjusted analysis showed that on-the-street homeless subjects were significantly more likely to share needles, share rinse water and practice back loading than the other two groups. Adjustment also indicated that sexual risk behaviors during the last 30 days were not significantly associated with residential status.

"Findings from this study present an added challenge to drug treatment and HIV prevention and treatment programs, to provide services that can address the additional needs of drug users suffering the stressors of homelessness," the researchers concluded.

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