Why do Puerto Rican injection drug users inject so often?

Abstract

Consistently, substance use research finds that Puerto Rican injection drug users (IDUs), both in Puerto Rico and on the US mainland, have rates of drug injection that are significantly higher than other drug injectors. These patterns put Puerto Rican drug injectors at very high risk for blood‐borne and other diseases including HIV/AIDS, hepatitis, tetanus, and endocarditis. Despite the life‐threatening consequences of the distinctive pattern of drug injection among Puerto Rican drug users, no satisfying explanation of this behavior has been developed. Data on injection patterns and sociodemographic characteristics from two National Institute on Drug Abuse funded national studies, the National AIDS Demonstration Research project and the Cooperative Agreement for AIDS Community‐based Outreach/Intervention Research Program, both of which had large samples of Puerto Rican drug injectors, are analyzed in this paper. These quantitative databases are supplemented by ethnographic research among Puerto Rican drug injectors from Hartford, CT to help explicate Puerto Rican drug use patterns. A model that integrates political economy, culture, and social psychology is presented to account for frequent drug injection among Puerto Rican IDUs. The public health implications of this model are discussed.