Puerto Ricans who do this are at the highest risk of contracting HIV

Hispanics have some of the highest rates of HIV, but Puerto Ricans who inject drugs top the list when it comes to those most-at-risk for contracting the virus. While this disparity has long been documented since early on in the AIDS epidemic, researchers have recently taken the investigation further.

According to the study “Addressing the HIV/AIDS epidemic among Puerto Rican people who inject drugs: the Need for a Multi-Region Approach,” published in the American Journal of Public Health, Puerto Ricans who inject drugs are not only among those most at-risk for HIV in the United States, they are the most at-risk in Puerto Rico as well.

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“We reviewed HIV-related data for Puerto Rican people who inject drugs (PRPWID) living in Puerto Rico and Northeastern US, which contains the highest concentration of Puerto Ricans out of any US region,” said in a statement Dr. Sherry Deren, senior research scientist at NYU College of Nursing. “Injection drug use as a risk for HIV continues to be over-represented among Puerto Ricans. Lower availability of HIV prevention tools (syringe exchange and drug treatment) and ART treatment challenges, for PWID in PR, contribute to higher HIV risk and incidence for PRPWID in both locations.”

Puerto Ricans who inject drugs account for 15.8 percent of all new Hispanic HIV cases, despite the fact Puerto Ricans only represent 9 percent of Hispanics in the United States. In Puerto Rico the numbers are even higher; people who inject drugs are responsible for more than 20 percent of new HIV cases and are driving up the numbers of heterosexual HIV contraction.

Researchers indicate PRPWID were once the group with the highest HIV rates in Puerto Rico, but recently the numbers show heterosexual HIV is the most common. They attribute this shift to the high number of Puerto Ricans who inject drugs, however, suggesting this group acts as a reservoir for others.

“Controlling heterosexual transmission of HIV will require controlling HIV infection among people who inject drugs, as those who inject drugs and are sexually active will serve as a continuing reservoir for future heterosexual transmission if injecting-related HIV transmission is not brought under control,” indicated Deren. She cautioned that the numbers would remain unchanged unless syringe exchange and drug treatment programs were re-evaluted, especially in Puerto Rico. Unfortunately, such programs in Puerto Rico have traditionally been underfunded.

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“The differences in the annual budgets have very important implications for reducing HIV transmission and other health problems among people who inject drugs,” said Deren.  “Larger budgets for such programs allows for a greater number of syringes to be exchanged, and for programs to offer other services in addition to the exchange, such as HIV screenings.”

At the moment, federal funds are banned from being used in syringe exchange programs in Puerto Rico, forcing many individuals to travel to the Northeastern U.S. if they want treatment. For many Puerto Ricans this is not a viable option, and the research team indicates those who do come to the continental U.S. for help often never find appropriate evidence-based treatment.