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Aponte-Meléndez Y, Eckhardt B, Fong C, Padilla A, Trinidad-Martínez W, Maldonado-Rodríguez E, Agront N, Mateu-Gelabert P. Prevalence and associated risk factors of hepatitis C antibody and RNA among people who inject drugs in Puerto Rico. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 160:209308. [PMID: 38301921 PMCID: PMC11060894 DOI: 10.1016/j.josat.2024.209308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/08/2023] [Accepted: 01/24/2024] [Indexed: 02/03/2024]
Abstract
INTRODUCTION As a public health crisis, hepatitis C viral infection (HCV) is highly prevalent among people who inject drugs (PWID). We aimed to assess factors associated with HCV antibody (Ab) and HCV ribonucleic acid (RNA) positivity among PWID in Puerto Rico. METHODS The study recruited a total of 150 persons in rural and peri-urban community settings through the respondent-driven sampling method and administered a structured questionnaire. We conducted HIV and HCV testing using dried blood spots (DBS). We examined correlates of HCV infection with sociodemographics, drug use patterns, and injection practices using regression in bivariate and multivariable analysis. RESULTS Of the 150 participants, 89 % were male; 11 % were female; 72 % identified as mixed race; and the median duration of drug injection was 17.8 years. The mean age was 43.1 years, with 64 % of the population being from 23 to 45 years old. Among study participants (n = 150), the prevalence of HCV Ab was 73 %, and HCV RNA was 53 %. Factors significantly associated with HCV Ab and RNA included older age, increasing years of injection, incarceration, injecting other people, and identifying as Black. The belief that syringe air blowing reduces HCV transmission was also independently associated with HCV Ab positivity. CONCLUSIONS Our findings regarding risk factors associated with HCV infection show the need to enhance prevention and control strategies for reducing transmission among PWID. Direct-acting antiviral treatment, sustained access to harm reduction, and culturally tailored services will be required to substantially reduce rates of HCV. Community-based treatment models and treatment in correctional settings are needed.
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Affiliation(s)
- Yesenia Aponte-Meléndez
- CUNY Graduate School of Public Health and Health Policy, Institute for Implementation Science in Population Health (ISPH), 55 West 125(th) street, New York, NY 10027, USA; NYU Rory Meyers College of Nursing, 433 1(st) Ave., New York, NY, 10010, USA.
| | - Benjamin Eckhardt
- New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA.
| | - Chunki Fong
- CUNY Graduate School of Public Health and Health Policy, Institute for Implementation Science in Population Health (ISPH), 55 West 125(th) street, New York, NY 10027, USA.
| | - Adriana Padilla
- CUNY Graduate School of Public Health and Health Policy, Institute for Implementation Science in Population Health (ISPH), 55 West 125(th) street, New York, NY 10027, USA.
| | - Wanda Trinidad-Martínez
- CUNY Graduate School of Public Health and Health Policy, Institute for Implementation Science in Population Health (ISPH), 55 West 125(th) street, New York, NY 10027, USA.
| | - Eric Maldonado-Rodríguez
- CUNY Graduate School of Public Health and Health Policy, Institute for Implementation Science in Population Health (ISPH), 55 West 125(th) street, New York, NY 10027, USA.
| | - Nancy Agront
- AbbVie Corp., Paseo Caribe Building Suite 22415 Ave Munoz Rivera San Juan, 00901, Puerto Rico.
| | - Pedro Mateu-Gelabert
- CUNY Graduate School of Public Health and Health Policy, Institute for Implementation Science in Population Health (ISPH), 55 West 125(th) street, New York, NY 10027, USA.
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Cano M, Mendoza N, Ignacio M, Rahman A, Daniulaityte R. Overdose deaths involving synthetic opioids: Racial/ethnic and educational disparities in the eastern and western US. Drug Alcohol Depend 2023; 251:110955. [PMID: 37699286 DOI: 10.1016/j.drugalcdep.2023.110955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/17/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND This study examined racial/ethnic and educational disparities in US synthetic opioid overdose mortality East and West of the Mississippi River. METHODS Using restricted-access 2018-2021 mortality data from the Centers for Disease Control and Prevention and population estimates from the American Community Survey, age-standardized rate ratios (SRRs) and 95% Confidence Intervals (CIs) were used to compare rates of synthetic opioid mortality by race/ethnicity and educational attainment level in the regions East and West of the Mississippi River. RESULTS Racial/ethnic disparities in synthetic opioid mortality rates, relative to the Non-Hispanic (NH) White population, were observed in the NH Black (SRR, 1.5 [95% CI, 1.5-1.6]) and NH American Indian/Alaska Native (SRR, 2.1 [95% CI, 1.9-2.2]) populations in the West, and the Puerto Rican (SRR, 1.3 [95% CI, 1.3-1.3]) and NH American Indian/Alaska Native (SRR, 1.5 [95% CI, 1.4-1.6]) populations in the East. Relative to those with a Bachelor's degree or higher: in the West, the synthetic opioid mortality rate was more than seven times as high for those with a high school diploma only (SRR 7.7 [95% CI, 7.4-8.0]), and in the East, approximately thirteen times as high for those with a high school diploma only (SRR, 13.0 [95% CI, 12.7-13.3]) or less than a high school diploma (SRR, 13.3 [95% CI, 13.0-13.7]). CONCLUSION Disparities in rates of synthetic opioid mortality differ in the eastern and western US, supporting tailored responses within each region.
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Affiliation(s)
- Manuel Cano
- School of Social Work, Arizona State University, Phoenix, AZ, USA.
| | - Natasha Mendoza
- School of Social Work, Arizona State University, Phoenix, AZ, USA
| | - Matt Ignacio
- School of Social Work, Arizona State University, Tucson, AZ, USA
| | - Abir Rahman
- Cabell-Huntington Health Department, Huntington, WV, USA
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Correa-Fernández V, Barazi AM, Chandra M, Anthony JC. Similarities and Differences in Alcohol & Other Drug Dependence Among Hispanic/Latino Subgroups: A Disaggregation Approach. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 5:100124. [PMID: 36844160 PMCID: PMC9949341 DOI: 10.1016/j.dadr.2022.100124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 11/10/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022]
Abstract
Background Hispanic/Latino (H/L) heritage civilians out-number all other non-White ethnic groups in the United States. When studied as one group, H/L diversity is ignored, including rates of drug misuse. This study's aim was to examine H/L diversity regarding drug dependence by disaggregating how the burdens of active alcohol or other drug dependence (AODD) might change if we were to address syndromes drug by drug. Method Studying non-institutionalized H/L residents from the National Surveys on Drug Use and Health (NSDUH) 2002-2013 probability samples, we utilized online Restricted-use Data Analysis System variables to identify ethnic heritage subgroups and active AODD via computerized self-interviews. We estimated case counts of AODD with analysis-weighted cross-tabulations and variances from Taylor series. Radar plots disclose AODD variations when we simulate the reductions of drug-specific AODD one by one. Results For all H/L heritage subgroups, the most substantial AODD decline might be achieved by reducing active alcohol dependence syndromes, followed by declines of cannabis dependence. The burdens due to active syndromes attributed to cocaine and pain relievers vary somewhat across subgroups. For the Puerto Rican subgroup, our estimates reveal potentially important burden reduction if active heroin dependence can be decreased. Conclusion A sizeable reduction in the H/L population health burden attributable to AODD syndromes might be achieved via the effective decline of alcohol and cannabis dependence among all subgroups. Future research includes a systematic replication with recent NSDUH survey data, as well as various stratifications. If replicated, the need for targeted drug-specific interventions among H/L will become unequivocal.
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Affiliation(s)
- Virmarie Correa-Fernández
- Department of Psychological, Health and Learning Sciences, University of Houston, 3657 Cullen Blvd, Room 491, Farish Hall, Houston, TX 77204-5029, United States,Corresponding author.
| | - Adnan M. Barazi
- Department of Epidemiology and Biostatistics, Michigan State University; 909 Wilson Road, Room 601, East Lansing, Michigan, 48824, United States,University of Maryland-College Park, United States
| | - Madhur Chandra
- Department of Epidemiology and Biostatistics, Michigan State University; 909 Wilson Road, Room 601, East Lansing, Michigan, 48824, United States,Michigan Department of Health and Human Services - WIC Division, United States
| | - James C. Anthony
- Department of Epidemiology and Biostatistics, Michigan State University; 909 Wilson Road, Room 601, East Lansing, Michigan, 48824, United States
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Gelpí-Acosta C, Cano M, Hagan H. Racial and ethnic data justice: The urgency of surveillance data disaggregation. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 4:100082. [PMID: 36712292 PMCID: PMC9881686 DOI: 10.1016/j.dadr.2022.100082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Disease and overdose surveillance across industrialized countries, including the United States (US), have historically relied upon racial and ethnic classifications such as Non-Hispanic Black, White, Asian and Hispanic/Latinx to characterize the populations it describes. These categories underestimate significant HIV, hepatitis C (HCV) and drug overdose variance within these groups, by both place of birth and ethnicity. For socioeconomically disadvantaged people of color in the US, frontline workers (i.e., harm reduction outreach workers, case managers, etc.) are a medullar entry point to the HIV, HCV, and drug misuse care continuums. Racial/ethnic data aggregates fail to characterize vulnerable groups in ways that can increase these workers’ efficacy. HIV, HCV, and overdose data disaggregation is urgent to end HIV and to control HCV and drug overdoses more effectively, and to also move closer to an anti-racist epidemiology.
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Affiliation(s)
- Camila Gelpí-Acosta
- LaGuardia Community College, City University of New York, USA,Corresponding author.
| | - Manuel Cano
- School of Social Work, Arizona State University, USA
| | - Holly Hagan
- School of Global Public Health, Center for Drug Use and HIV/HCV Research, NYU, USA
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Variation in US drug overdose mortality within and between Hispanic/Latine subgroups: A disaggregation of national data. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Cano M, Agan A, Bandoian L, Larochelle L. Individual and County-Level Disparities in Drug and Opioid Overdose Mortality for Hispanic Men in Massachusetts and the Northeast United States. Subst Use Misuse 2022; 57:1131-1143. [PMID: 35459423 DOI: 10.1080/10826084.2022.2064507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study aimed to identify individual- and county-level inequalities that may underlie disparities in drug overdose mortality for Hispanic men in Massachusetts and the broader Northeast region. METHODS The study first used data from the State Unintentional Drug Overdose Reporting System to compare the 635 Hispanic and 3593 Non-Hispanic (NH) White men who died of unintentional/undetermined opioid-related overdoses in Massachusetts in 2016-2018. Next, the study used 2015-2019 data from the Multiple Cause of Death online platform to: a) compare rates of drug overdose mortality in Hispanic versus NH White men in 54 counties in the Northeast United States; and b) examine associations with inequalities in poverty, educational attainment, unemployment, and uninsurance (from 2015-2019 American Community Survey data). RESULTS At the individual level, in Massachusetts, Hispanic and NH White men who died of opioid-related overdose differed in terms of educational attainment, birthplace, urbanicity, substance use disorder treatment history, and specific drugs involved in death. At the county level, in the Northeast region, each one-standard deviation increase in the ratio of the Hispanic to NH White poverty rate was associated with a 27% increase in the ratio of Hispanic to NH White male overdose mortality; each one-standard deviation increase in the ratio of the Hispanic to NH White unemployment rate was associated with a 43% increase in the ratio of Hispanic to NH White male overdose mortality. CONCLUSIONS Findings underscore the importance of equitable interventions and efforts to address inequalities in social determinants of health for Hispanic populations in the Northeast.
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Affiliation(s)
- Manuel Cano
- Department of Social Work, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Anna Agan
- Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Lisa Bandoian
- Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Lauren Larochelle
- Massachusetts Department of Public Health, Boston, Massachusetts, USA
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