Prevalence and Risk Factors associated with Homelessness among Drug Users in Puerto Rico.

Objective: This study aimed to determine the association between years of drug injection and homelessness among drug users in rural Puerto Rico.

Methods: Respondent-driven sampling methods allowed us to obtain a sample of 315 intravenous drug users (IDUs) in rural Puerto Rico. Information about sociodemographic characteristics, drug use patterns, homelessness and risk behaviors was obtained through structured interviews.

Establishing trust in HIV/HCV research among people who inject drugs (PWID): Insights from empirical research.

Background: The establishment of trust between researchers and participants is critical to advance HIV and HCV prevention particularly among people who inject drugs (PWID) and other marginalized populations, yet empirical research on how to establish and maintain trust in the course of community health research is lacking. This paper documents ideas about trust between research participants and researchers amongst a sub-sample of PWID who were enrolled in a large, multi-year community health study of social networks and HIV/HCV risk that was recently conducted in rural Puerto Rico.

Methods: Qualitative research was nested within a multi-year Social Network and HIV/HCV Risk study involving N = 360 PWID > 18 years of age living in four small, rural Puerto Rican communities.

Eight-Legged Encounters-Arachnids, Volunteers, and Art help to Bridge the Gap between Informal and Formal Science Learning.

Increased integration and synergy between formal and informal learning environments is proposed to provide multiple benefits to science learners. In an effort to better bridge these two learning contexts, we developed an educational model that employs the charismatic nature of arachnids to engage the public of all ages in science learning; learning that aligns with the Next Generation Science Standards (NGSS Disciplinary Core Ideas associated with Biodiversity and Evolution). We created, implemented, and evaluated a family-focused, interactive science event-)-which encompasses more than twenty modular activities.

Injection Partners, HCV, and HIV Status among Rural Persons Who Inject Drugs in Puerto Rico.

Background: The prevalence of hepatitis C (HCV) and HIV among persons who inject drugs (PWID) and the ability of these diseases to spread through injection networks are well documented in urban areas. However, less is known about injection behaviors in rural areas.

Objectives: This study focuses on the association between the number of self-reported injection partners with the PWID's self-reported HCV and HIV status.

Association between alcohol consumption and injection and sexual risk behaviors among people who inject drugs in rural Puerto Rico.

Although alcohol use has been associated with risky behavior generally, the relationship between alcohol use and multiple types of risk behaviors that could lead to the acquisition and transmission of HIV and hepatitis C (HCV) among people who inject drugs (PWID) has not been fully examined. The current study seeks to contribute to the understanding of how alcohol use is related to both injection risk and sexual risk, among a non-treatment, cross-sectional sample of mostly male PWID in rural Puerto Rico (n=315). "At-risk" alcohol use was defined as consuming ≥14 drinks per week for males and ≥7 drinks per week for females.

Social Determinants of HIV/HCV Co-Infection: A case Study from People Who Inject Drugs in Rural Puerto Rico.

• Co-infection correlates with age, longer period of drug use, medical insurance coverage and sexual identity. • LGBT PWID are vulnerable to co-infection. Stigma, commercial sex and violence compounds risk.

The Relationship between Survival Sex and Borderline Personality Disorder Symptoms in a High Risk Female Population.

Engaging in survival sex and mental illness are overrepresented within homeless populations. This article assesses the relationship between symptoms of borderline personality disorder (BPD) and engaging in survival sex among homeless women. One hundred and fifty-eight homeless women completed surveys on self-reported BPD symptomology and sexual history.

Rural and urban injection drug use in Puerto Rico: Network implications for human immunodeficiency virus and hepatitis C virus infection.

Understanding the short- and long-term transmission dynamics of blood-borne illnesses in network contexts represents an important public health priority for people who inject drugs and the general population that surrounds them. The purpose of this article is to compare the risk networks of urban and rural people who inject drugs in Puerto Rico. In the current study, network characteristics are drawn from the sampling "trees" used to recruit participants to the study.

Using Network Sampling and Recruitment Data to Understand Social Structures Related to Community Health in a Population of People Who Inject Drugs in Rural Puerto Rico.

Objective: This research examined the social network and recruitment patterns of a sample of people who inject drugs (PWIDs) in rural Puerto Rico, in an attempt to uncover systematic clustering and between-group social boundaries that potentially influence disease spread.

Methods: Respondent driven sampling was utilized to obtain a sample of PWID in rural Puerto Rico. Through eight initial "seeds", 317 injection drug users were recruited.

Differential access to syringe exchange and other prevention activities among people who inject drugs in rural and urban areas of Puerto Rico.

Background: Injection drug use and its associated blood-borne infections has become a rapidly increasing problem in rural areas of the US recently. Syringe exchange programs have been shown to be effective for reducing transmission of blood borne infections, however access to these prevention efforts may be limited in rural areas.

Methods: This paper utilizes two separate community samples of people who inject drugs (PWID) in Puerto Rico to achieve the following research objectives: (1) compare rural and urban access to syringe exchange programs, free sterile syringes and other HIV/HCV prevention activities, and (2) examine whether utilization of prevention activities is associated with lower injection risk behaviors.

Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review.

During the United States economic recession of 2008-2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in substance abuse and mental health.

Understanding differences in HIV/HCV prevalence according to differentiated risk behaviors in a sample of PWID in rural Puerto Rico.

Background: Blood contained in needles and injection equipment has been identified as a vector for HIV and HCV transmission among people who inject drugs (PWID). Yet, there is often a wide discrepancy in prevalence for both viruses. While microbiological differences between viruses influence prevalence, other variables associated with the way drugs are acquired and used, also play a role.

Borderline personality disorder and Axis I psychiatric and substance use disorders among women experiencing homelessness in three US cities.

Purpose: In this study, we report prevalence rates of borderline personality disorder (BPD) and Axis I psychiatric and substance use disorders among randomly selected women who were experiencing episodes of homelessness in three US cities.

Methods: The sample consists of 156 women, 79 from Omaha, NE, 39 from Pittsburgh, PA, and 38 from Portland, OR. It included 140 women from shelters and 16 women from meal locations.

Characteristics of Mothers Caring for Children During Episodes of Homelessness.

This study provides a description of the physical, psychological, and substance use problems of adult homeless women who are and are not caring for children. We also examined differences in the characteristics of these two groups of women. Interviews were conducted with 148 homeless women from three mid-sized U.