Examining the Determinants of HIV/HCV Co-Infection in Puerto Rico

Puerto Rico has the fourth highest rate of HIV infection in the entire United States. The disease has been devastating to the island territory in many other ways as well: the HIV death rate for Puerto Ricans is four times higher than the national average. These dismal outcomes are further heightened by the prevalence of HIV/HCV co-infection, which triples the risk of liver disease, liver failure, and death. People who use injection drugs are the predominant demographic affected by this co-infection, with 75% of persons diagnosed with both HIV and HCV being PWID.

REACH researchers Roberto Abadie, Melissa Welch-Lazoritz, Bilal Khan, Kirk Dombrowski recently set out to examine the social determinants of those co-infected with HIV and HCV in Puerto Rico. Their study analyzed data from 315 participants from the rural Puerto Rican PWID community. The findings of the case study were published in Addictive Behaviors Report earlier this year in an article titled “Social determinants of HIV/HCV co-infection: A case study from people who inject drugs in rural Puerto Rico.”

The REACH team found that 6% of IDU participants were co-infected with HIV and all of these participants were also infected with Hep C. Consequently, an HIV diagnosis was a strong predictor for being infected with HCV as well. Among the tested correlates, those co-infected with HIV/HCV were much more likely to be lesbian, gay, and bisexual than IDUs who were not co-infected. Those co-infected were also more likely to be older and have a longer duration of injection drug use were also more likely to be co-infected. Notably, PWID who were co-infected had greater access to the healthcare system and treatment, further emphasizing the devastating epidemic of HCV on the island that largely goes untreated.

The findings out of Puerto Rico regarding HIV/HCV co-infection should help intervention strategies be better prepared to effectively respond to the island’s needs in preventing, screening, and treating these infectious diseases.

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