Where Becomes How: Spatial Context and Risk Behaviors Among People Who Inject Drugs in Puerto Rico

• In Event: 2234 - Social Dimensions of AIDS

Abstract

While spatial interventions such as safe injection facilities have found success in mitigating injection risk for people who inject drugs (PWID) in urban areas, potential for such interventions in rural areas is only sparsely examined. Furthermore, while illicit semi-public spaces for PWID to inject, commonly called shooting galleries, have traditionally been found to have riskier behavior with respect to Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV), more recent research suggests a complicated risk profile. We explore these two areas by analyzing injection behaviors and injection location of pairs injecting together in rural Puerto Rico, with a participant sample size of 109 and an edge sample size of 468. We find that among our sample that equipment sharing is associated with higher odds of using a shooting gallery, but that sharing needles, knowing a partner’s HIV status, and having a very close relationship with a use partner decreases the odds of using a shooting gallery with that partner. The number of years the pair had been injecting together, knowing an alter’s HCV status, and back loading was not associated with use of shooting galleries. Although the higher strength of relationships outside of shooting galleries explains these relationships to a small degree, it is not large enough to do so fully. Our work shows that rural shooting galleries in Puerto Rico have complex associations with risk behavior that appear to differ from the urban settings described in prior research, and that semi public injection spaces should not be viewed as holding unilaterally more viral infection risk for PWID.

Authors

• Logan Steven Young, University of Washington

• Patrick Habecker, University of Nebraska-Lincoln

• Kirk Dombrowski, University of Nebraska-Lincoln