ResearchProjects

Puerto Rican drug users have been over-represented among AIDS cases in the U.S. since early in the epidemic. Differences in risk behaviors have been identified between Puerto Rican drug injectors and crack smokers who reside on the island of Puerto Rico and those who reside in New York. The mobility and migration of Puerto Ricans between New York and Puerto Rico provided a unique opportunity to examine the impact of diverse environments on risk behaviors in a single ethnic group.

The first project examined psychological, social, health-related, cultural and environmental influences on drug and sex-related risk behaviors and assessed the impact of these factors on changes in risk behavior. It also measured whether risk behavior and risk behavior change were affected by migration, residency, acculturation, mobility patterns and HIV status. The second project continued to monitor HIV risk behaviors, new HIV infections and factors related to these new infections among these participants, as well as factors related to mortality.

The findings from both projects were used to develop and test an intervention for Puerto Rican migrant drug users (defined as those who previously used heroin or cocaine in Puerto Rico and used drugs in the NY area) – the Bienvenidos project.

STUDY FINDINGS

• Drug users in Puerto Rico became infected with HIV at a rate four times higher than Puerto Rican drug users in New York.
• Mortality was three times higher among those residing in Puerto Rico.
• Those in Puerto Rico were more likely to engage in injection drug use and sexual behaviors that put them at risk of becoming infected with HIV.
• There were few HIV prevention programs, such as syringe exchange and methadone, in Puerto Rico. The availability of drug treatment programs in Puerto Rico declined during the study period.
• Significantly fewer HIV+ drug users in Puerto Rico were taking HIV medications than in New York.

Abstract on NIH RePORTER

Kang SY, Deren S, Colon HM (2011).
Differential gender effects of depression on use of HIV medications among HIV-positive Puerto Rican drug users
AIDS Care, 23 (11), 1467-1471. doi: 10.1080/09540121.2011.565022.

Kang SY, Deren S (2009).
Factors mediating and moderating the relationship between gender and utilization of health care among Puerto Rican drug users in New York
Drug and Alcohol Dependence, 102 (1-3), 138-143. doi: 10.1016/j.drugalcdep.2009.02.011. PMCID: PMC2674114.

Kang SY, Deren S, Colon H (2009).
Gender comparisons of factors associated with drug treatment utilization among Puerto Rican drug users
American Journal of Drug and Alcohol Abuse, 35 (2), 73-79. doi: 10.1080/00952990802585414.

Kang SY, Deren S, Mino M, Cortes DE (2009).
Biculturality and HIV-risk behaviors among Puerto Rican drug users in New York City
Substance Use and Misuse, 44 (4), 578-592. doi: 10.1080/10826080802487341.

Andia JF, Deren S, Robles RR, Kang SY, Colon HM (2008).
Peer norms and sharing of injection paraphernalia among Puerto Rican injection drug users in New York and Puerto Rico
AIDS Education and Prevention, 20 (3), 249-257. doi: 10.1521/aeap.2008.20.3.249.

Deren S, Strauss S, Kang SY, Colon HM, Robles RR (2008).
Sex risk behaviors of drug users: A dual site study of predictors over time
AIDS Education and Prevention, 20 (4), 325-337. doi: 10.1521/aeap.2008.20.4.325.

Cleland CM, Deren S, Fuller CM, Blaney S, McMahon JM, Tortu S, Des Jarlais DC, Vlahov D (2007).
Syringe disposal among injection drug users in Harlem and the Bronx during the New York State Expanded Syringe Access Demonstration Program
Health Education and Behavior, 34 (2), 390-403. doi: 10.1177/1090198106288560.

Deren S, Kang SY, Colon HM, Robles RR (2007).
Predictors of injection drug use cessation among Puerto Rican drug injectors in New York and Puerto Rico
American Journal of Drug and Alcohol Abuse, 33 (2), 291-299. doi: 10.1080/00952990601175037.

Deren S, Kang SY, Colon HM, Robles RR (2007).
The Puerto Rico-New York airbridge for drug users: Description and relationship to HIV risk behaviors
Journal of Urban Health, 84 (2), 243-254. doi: 10.1007/s11524-006-9151-5. PMCID: PMC2231641.

Colon HM, Deren S, Robles RR, Kang SY, Cabassa M, Sahai H (2006).
A comparative study of mortality among Puerto Rican injection drug users in East Harlem, New York, and Bayamon, Puerto Rico
Journal of Urban Health, 83 (6), 1114-1126. doi: 10.1007/s11524-006-9088-8. PMCID: PMC3261282.

Finlinson HA, Oliver-Velez D, Deren S, Cant JGH, Colon HM, Robles RR, Kang SY, Andia JF (2006).
A longitudinal study of syringe acquisition by Puerto Rican injection drug users in New York and Puerto Rico: Implications for syringe exchange and distribution programs
Substance Use and Misuse, 41 (9), 1313-1336. doi: 10.1080/10826080600885092.

Mino M, Deren S, Kang SY (2006).
Social support and HIV-related injection risk among Puerto Rican migrant and nonmigrant injection drug users recruited in New York City
AIDS Education and Prevention, 18 (1), 81-90. doi: 10.1521/aeap.2006.18.1.81.

Robles RR, Matos TD, Deren S, Colon HM, Sahai H, Marrero CA, Reyes JC, Andia J, Shepard EW (2006).
Drug treatment disparities among Hispanic drug-using women in Puerto Rico and New York City
Health Policy, 75 (2), 159-169. doi: 10.1016/j.healthpol.2005.03.004.

Andia JF, Deren S, Robles RR, Kang SY, Colon HM, Oliver-Velez D, Finlinson A (2005).
Factors associated with injection and noninjection drug use during incarceration among Puerto Rican drug injectors in New York and Puerto Rico
Prison Journal, 85 (3), 329-342. doi: 10.1177/0032885505279373.

Deren S, Shedlin M, Decena CU, Mino M (2005).
Research challenges to the study of HIV/AIDS among migrant and immigrant Hispanic populations in the United States
Journal of Urban Health, 82 (2 Suppl 3), iii13-iii25. doi: 10.1093/jurban/jti060. PMCID: PMC3455897.

Kang SY, Deren S, Andia J, Colon HM, Robles RR (2005).
Egocentric HIV risk networks among Puerto Rican crack users in New York and Puerto Rico: Impact on sex risk behaviors over time
AIDS Education and Prevention, 17 (1), 53-67. doi: 10.1521/aeap.17.1.53.58684.

Kang SY, Deren S, Andia J, Colon HM, Robles R, Oliver-Velez D (2005).
HIV transmission behaviors in jail/prison among Puerto Rican drug injectors in New York and Puerto Rico
AIDS and Behavior, 9 (3), 377-386. doi: 10.1007/s10461-005-9011-4.

Pouget ER, Deren S, Fuller CM, Blaney S, McMahon JM, Kang SY, Tortu S, Andia JF, Des Jarlais DC, Vlahov D (2005).
Receptive syringe sharing among injection drug users in Harlem and the Bronx during the New York State Expanded Syringe Access Demonstration Program
Journal of Acquired Immune Deficiency Syndromes, 39 (4), 471-477.

Deren S, Kang SY, Colon HM, Andia JF, Robles RR (2004).
HIV incidence among high-risk Puerto Rican drug users: A comparison of East Harlem, New York, and Bayamon, Puerto Rico
Journal of Acquired Immune Deficiency Syndromes, 36 (5), 1067-1074.

Kang SY, Deren S, Andia J, Colon HM, Robles R (2004).
Effects of changes in perceived self-efficacy on HIV risk behaviors over time
Addictive Behaviors, 29 (3), 567-574. doi: 10.1016/j.addbeh.2003.08.026.

Andia JF, Deren S, Friedman SR, Winick C, Kang SY, Palij M, Robles RR, Colon HM, Oliver-Velez D, Finlinson A (2003).
Towards an HIV role theory: Drug-related peer beliefs and role strain indicators as predictors of injection risk behaviors among Puerto Rican injection drug users in New York and Puerto Rico
Journal of Drug Issues, 33 (4), 963-982. doi: 10.1177/002204260303300409 .

Cortes DE, Deren S, Andia J, Colon H, Robles R, Kang SY (2003).
The use of the Puerto Rican Biculturality Scale with Puerto Rican drug users in New York and Puerto Rico
Journal of Psychoactive Drugs, 35 (2), 197-207. doi: 10.1080/02791072.2003.10400001.

Deren S, Fuller C, Pouget ER, Blaney S, Tortu S, Kang SY, McMahon JM, Andia JF, Des Jarlais DC, Johnson B, Rosenblum A, Vlahov D (2003).
Impact of expanding syringe access in New York on sources of syringes for injection drug users in Harlem and the Bronx, NYC, USA
International Journal of Drug Policy, 14 (5-6), 373-379. doi: 10.1016/S0955-3959(03)00137-3.

Deren S, Kang SY, Colon HM, Andia JF, Robles RR, Oliver-Velez D, Finlinson A (2003).
Migration and HIV risk behaviors: Puerto Rican drug injectors in New York City and Puerto Rico
American Journal of Public Health, 93 (5), 812-816. doi: 10.2105/AJPH.93.5.812. PMCID: PMC1447844 .

Deren S, Kang SY, Rapkin B, Robles RR, Andia JF, Colon HM (2003).
The utility of the PRECEDE model in predicting HIV risk behaviors among Puerto Rican injection drug users
AIDS and Behavior, 7 (4), 405-412. doi: 10.1023/B:AIBE.0000004732.74061.3f.

Deren S, Oliver-Velez D, Finlinson A, Robles R, Andia J, Colon HM, Kang SY, Shedlin M (2003).
Integrating qualitative and quantitative methods: Comparing HIV-related risk behaviors among Puerto Rican drug users in Puerto Rico and New York
Substance Use and Misuse, 38 (1), 1-24. doi: 10.1081/JA-120016563.

Finlinson HA, Oliver-Velez D, Deren S, Cant JGH, Colon HM, Robles RR, Andia JF (2003).
Puerto Rican drug users’ experiences of physical and sexual abuse: Comparisons based on gender and developmental stage
Violence Against Women, 9 (7), 839-858. doi: 10.1177/1077801203009007005.

Finlinson HA, Robles RR, Colon HM, Lopez MS, Negron MD, Oliver-Velez D, Deren S, Andia JF, Cant JGH (2003).
Puerto Rican drug users’ experiences of physical and sexual abuse: Comparisons based on sexual identities
Journal of Sex Research, 40 (3), 277-285. doi: 10.1080/00224490309552192.

Oliver-Velez D, Deren S, Finlinson A, Shedlin M, Robles RR, Andia J, Colon HM, Kang SY (2003).
Sexual risk behaviors of Puerto Rican drug users in East Harlem, New York and Bayamon, Puerto Rico
Culture, Health and Sexuality, 5 (1), 19-35. doi: 10.1080/713804636.

Robles RR, Matos TD, Colon HM, Deren S, Reyes JC, Andia J, Marrero CA, Sahai H (2003).
Determinants of health care use among Puerto Rican drug users in Puerto Rico and New York City
Clinical Infectious Diseases, 37 (Suppl 5), S392-S403. doi: 10.1086/377552.

Friedman SR, Kang SY, Deren S, Robles R, Colon HM, Andia J, Oliver-Velez D, Finlinson A (2002).
Drug-scene roles and HIV risk among Puerto Rican injection drug users in East Harlem, New York and Bayamon, Puerto Rico
Journal of Psychoactive Drugs, 34 (4), 363-369. doi: 10.1080/02791072.2002.10399977.

Oliver-Velez D, Finlinson HA, Deren S, Robles RR, Shedlin M, Andia J, Colon H (2002).
Mapping the Air-Bridge locations: The application of ethnographic mapping techniques to a study of HIV risk behavior determinant in East Harlem, New York, and Bayamon, Puerto Rico
Human Organization, 61 (3), 262-276. doi: 10.17730/humo.61.3.99nm1tuxan9yd7ap.

Andia JF, Deren S, Kang SY, Robles RR, Colon HM, Oliver-Velez D, Finlinson A, Beardsley M, Friedman SR (2001).
Residential status and HIV risk behaviors among Puerto Rican drug injectors in New York and Puerto Rico
American Journal of Drug and Alcohol Abuse, 27 (4), 719-735. doi: 10.1081/ADA-100107664.

Colon HM, Finlinson HA, Robles RR, Deren S, Andia J, Kang SY, Oliver-Velez D (2001).
Joint drug purchases and drug preparation risk behaviors among injection drug users
AIDS and Behavior, 5 (1), 85-96. doi: 10.1023/A:1009515723223.

Colon HM, Robles RR, Deren S, Sahai H, Finlinson HA, Andia J, Cruz MA, Kang SY, Oliver-Velez D (2001).
Between-city variation in frequency of injection among Puerto Rican injection drug users: East Harlem, New York, and Bayamon, Puerto Rico
Journal of Acquired Immune Deficiency Syndromes, 27 (4), 405-413.

Deren S, Robles R, Andia J, Colon HM, Kang SY, Perlis T (2001).
Trends in HIV seroprevalence and needle sharing among Puerto Rican drug injectors in Puerto Rico and New York: 1992-1999
Journal of Acquired Immune Deficiency Syndromes, 26 (2), 164-169.

Kang SY, Deren S, Andia J, Colon HM, Robles RR (2001).
Gender differences in HIV risk behaviors among Puerto Rican drug injectors by awareness of HIV seropositive status
AIDS and Behavior, 5 (3), 241-249. doi: 10.1023/A:1011340626507.

Finlinson HA, Oliver-Velez D, Colon HM, Deren S, Robles RR, Beardsley M, Cant JGH, Andia J, Soto-Lopez M (2000).
Syringe acquisition and use of syringe exchange programs by Puerto Rican drug injectors in New York and Puerto Rico: Comparisons based on quantitative and qualitative methods
AIDS and Behavior, 4 (4), 341-351. doi: 10.1023/A:1026498321919.

Finlinson HA, Colon HM, Robles RR, Deren S, Soto Lopez M, Munoz A (1999).
Access to sterile syringes by injection drug users in Puerto Rico
Human Organization, 58 (2), 201-210. doi: 10.17730/humo.58.2.v136726573m8t608.

ARIBBA: Alliance for Research in El Barrio and Bayamon
February 2005