S Deren

..The findings indicate that providing multiple sources of safe syringes for IDUs is necessary...

..The integration of qualitative and quantitative methods can enhance comparability and understanding of findings, particularly when there are differences in behaviors between communities...

..We compared injection-related HIV risk behaviors of Puerto Rican current injection drug users (IDUs) living in New York City and in Puerto Rico who also had injected in the other location with those who had not...

..However, only having primary partners was significant in longer-term behaviors. Results indicated the need for enhancing self-efficacy and for developing risk reduction strategies related to community differences...

..The need to address risks associated with joint drug purchasing in both locations and to enhance efforts to reduce risks among IDUs in Puerto Rico is indicated...

..The need to address sexual risk behaviors in both locations was also indicated. Resources focusing on reducing HIV transmission in the Caribbean should include efforts to target the drug use-HIV epidemic in PR...

..80; PR: AOR = 3.10). Increasing availability of methadone maintenance treatment, especially in PR, was indicated...

..05). Implications included the need to enhance risk reduction efforts for IDUs in PR and address sexual risk among mobile drug users...

..Continued study of the sociocultural and contextual factors affecting HIV risk for mobile populations, and addressing the research challenges, is crucial to developing effective intervention programs...

..For the purpose of this paper, the term "migrant" was used to designate Puerto Rican drug users who had used drugs in Puerto Rico and were recruited in New York or New Jersey)...

..Responses included increased use of drugs and increased demand for drug treatment. The wide range of responses indicates that continued monitoring of the impact may be needed to assess long-term effects...

..This study assessed recent trends in HIV seroprevalence among injecting drug users in New York City...

..Efforts to identify concerns of new admissions early in treatment, and programs to continue drug treatment services to incarcerated clients, are indicated...

..High-risk behaviors were more likely among homeless IDUs in both sites. Programs to provide housing and target outreach and other prevention programs for homeless IDUs would be helpful in reducing HIV risk...

..Aggressive and innovative interventions are needed for women who exchange sex. AIDS research must investigate how socioeconomic factors impact women's risk for HIV infection...

..Ongoing epidemiologic studies to monitor the epidemic and continued prevention efforts to help maintain or further these declines are needed, particularly to address the higher rates of needle sharing in Puerto Rico...

..The identification of subgroups who may be most resistant to reducing drug use can be helpful in developing more effective interventions...

..More research attention should be focused on examining the social context of HIV risk in order to develop innovative intervention strategies which focus on the link between contextual factors and HIV infection...

..Educational efforts should be enhanced to reach those who continue to perceive barriers to ESAP...

..Prevention programs to reduce indirect sharing behaviors should take into consideration different types of risk norms in order to reduce indirect sharing risk behaviors...

..Although further research is needed, drug-scene role-holders should be targeted for interventions to affect their own risk and their communications with others...

..10) and between gender and injection drug use (p<.10). CONCLUSIONS: The findings support a need for drug treatment programs that include specialized therapies for those who suffered childhood abuse and neglect experiences...

..Future research should investigate the relationship between gender and other factors (e.g., ethnicity, geographic location) associated with HIV risk...

..This would help them to identify and intervene promptly with those in greatest need of support for remaining in treatment...

..Programs for these populations should also take into account the different risk behaviors among different racial/ethnic groups, in order to tailor culturally sensitive programs for HIV care and intervention...

..More detailed information on disposal practices is needed to capture the continuum from least to most safe practices and variation within individuals...

..The study's limitations have been noted...

..Interventions of greater duration and intensity, and which address multiple levels of influence (e.g., social, structural), may be needed to increase screening rates further...

..The findings also indicate an on-going need for mental and other health services for drug users who have been victims of abuse...

..The findings demonstrate the importance of family and social support for HIV-positive drug users and also suggest a need for special attention to those who have childhood sexual abuse experience...

..Results of the ethnographic component of this study are summarized. The role of ethnographic methods in implementing and evaluating this kind of intervention is also discussed...

..This study examined gender-specific effects of social bonds, network characteristics, and other factors on drug treatment enrollment among Puerto Rican drug users...

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..Retention in a Methadone Maintenance Treatment Program (MMTP) is predictive of abstaining from heroin and has other benefits. Many individuals leave treatment before they experience these positive outcomes...

..HIV/AIDS prevention programs should include a focus on enhancing self-efficacy for reducing risk behaviors...

..87, CI = 1.02-3.43; p = .041) among nonmigrants. The findings suggest that though migrants have less support than nonmigrants do, their support reduces risk and thus their likelihood of injection-related HIV infection...

..More attention to sex risk behaviors are needed in HIV/AIDS prevention and education programs...

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..The findings indicate a need for effective drug treatment programs inside jail/prisons to reduce HIV-related risk behaviors among drug injectors during incarceration and after release...

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..Enhancing access to services for IDUs in the boroughs outside Manhattan may be needed to continue the positive trends in all areas of New York City...

..Recommendations for future efforts in training drug treatment patients as outreach workers are provided...

..This paper describes the basis for development of the intervention, summarizes the methodology being used, and provides preliminary data on participation in the Alternative Program...

..This article also examines the relevance of the study of acculturation scales that can assist in identifying the influences of the cultures of origin and destination on substance abuse and HIV risk behaviors...

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..Although Puerto Rican drug users in Puerto Rico are not an ethnic minority, they reported significant disparities in health services use compared with Puerto Rican drug users in New York...

..The only source of free syringes, the SEP, permitted more syringes to be exchanged but the increase was not statistically significant. Implications for syringe exchange and distribution programs are discussed...

..Findings from these studies can help in developing appropriate public health policy and science-based drug treatment programs to eliminate disparities such as the ones detected in this study...

..Furthermore, these results point to an urgent need to reduce excess mortality among IDUs in Puerto Rico...

..The results of this study will have implications for conducting interventions with migrant drug users, and will enhance our knowledge regarding multi-level interventions to reduce HIV risk. ..

..Linear and logistic regression techniques will be used to assess relationships between the potential determinants and both current risk behaviors and risk behavior changes. ..