PIs Kirk Dombrowski (UNL), Bilal Khan (CUNY), Juan Carlos Reyes (UPRMC); Project Director Melissa Welch Lazoritz (UNL); Senior Investigators Roberto Abadie (UNL), Camila Gelpi-Acosta (CUNY); Consultants Richard Garfein (UCSD); Ric Curtis (CUNY)

Injection Risk Networks in Rural Puerto Rico

The most recent HIV surveillance data from the Centers for Disease Control indicates that Puerto Rico hosts one of the highest incidences of HIV infection in the United States. In 2010, the territory reported 28.2 new HIV infections per 100,000 residents, a rate over 1.5 times that of the US average and the third highest among all 56 US states and dependent territories. Yet among 103 major metropolitan areas, San Juan was ranked only 20th in terms of new diagnoses of HIV in the same year. In Puerto Rico, rural rather than urban communities, contribute disproportionately to the overall HIV rate. Further, over 20 percent of new diagnoses in Puerto Rico listed injection drug use as their cause, compared to 8.3 percent in the continental US. Clearly, these discrepancies point to a very different epidemic than what we are used to seeing on the US mainland, where HIV infection remains largely an urban problem.
The extent and underlying behavioral and network structural causes of this rural epidemic remain largely unknown. This 5 year project will investigate the social network contexts of HIV and HCV infection in four rural communities in Puerto Rico, collecting data that will allow us to model the spread of both viruses throughout the Territory. In the process, we will document HIV and HCV prevalence and incidence for injecting drug users in the region, and develop a framework for interventions aimed at these unique problems.
The project involves collaboration between the University of Nebraska-Lincoln, John Jay College CUNY, the Medical School of the University of Puerto Rico, and the University of California San Diego. Our local partner for the project is El Punto en la Montaña. Fieldwork and testing are anticipated to begin in early January, 2015


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