Researchers in the REACH Lab recently published a paper to the Journal of Ethnicity in Substance Abuse alongside employees from the Puerto Rico Department of Health to examine Rural/Urban differences in risk networks and the spread of HIV and Hepatitis C.
Researchers examined injection drug use in San Juan and in four rural towns in the mountainous area of central Puerto Rico, and the data used to compare drug use in these settings was gathered by Respondent-Driven Sampling (RDS). RDS was used to find differences in gender, income, age, perceived HCV status, participation in drug treatment efforts, frequency of various substance use, and the frequency of sharing injection equipment between rural and urban populations.
Researchers found very little difference in age, unemployment status, perceived HCV status, use of speedball (heroin and cocaine mixtures), and frequency of sharing injection equipment between these rural and urban populations. The urban population had higher percentages of women in its sample (17.5% vs. 9.2%), lower average income (91% vs. 80% earning less than $5,000 annually), fewer people participating in drug treatment (67% vs. 81% in their lifetimes), fewer people drinking (71% vs. 51% in the last year), fewer people binge drinking (57% vs. 37% in the last year), and higher average injection frequency (92.7% vs. 84.8% injecting at least once a day).
The team compared characteristics of these populations in hopes of better understanding the transmission of disease through an injection drug use network. These findings suggest different levels and kinds of network affiliation in rural and urban communities, meaning that PWID interact with characteristically similar individuals based on different traits given rural and urban settings. Finding differences in gender and income between rural and urban populations will then lead to different intervention strategies and ways that we work with these different communities.