UNL sociologist studies HIV spread in rural Puerto Rico
Lincoln, Neb., August 14th, 2014
Puerto Rico has one of the highest HIV rates in the United States, primarily
from drug users sharing needles. To help prevent HIV infections, a University of Nebraska-Lincoln sociologist is using his expertise in
studying how people form social connections to explore how drug users' social lives influence the spread of HIV. Kirk Dombrowski,
head of UNL's Minority Health Disparities Initiative, recently received $2.9 million from the National Institutes of Health's
National Institute on Drug Abuse for a five-year study investigating how HIV spreads among Puerto Rican drug users.
Ultimately, this research should identify effective, cost-efficient prevention strategies targeting HIV infections in rural areas.
While HIV infections on the U.S. mainland occur almost exclusively
in large cities, Puerto Rico's HIV rate is escalating primarily in rural areas. A government slum-clearing program pushed many of the
island's poor people into rural areas without jobs.
"So people who had minor drug problems and a community, now have no
one around them and major drug problems," Dombrowski said.
Statistics illustrate the rural nature of HIV prevalence in Puerto Rico.
The U.S. territory ranks in the top 5 percent of states and territories in HIV prevalence per capita, while its only city, San Juan,
ranks in just the top 20 percent of U.S. cities.
Dombrowski's team is working with El Punto de la Montana, a nonprofit
organization that supplies drug users with clean needles, to survey and interview users and to understand how their social relationships
form, who they share needles with, how information is communicated and other information. Researchers will also know who becomes
infected with HIV during that time.
Computers will help analyze how social networks evolve over time in
relation to risky behavior. As patterns emerge, Dombrowski and his collaborators from the City University of New York and the
University of Puerto Rico School of Medicine can determine which social factors influence the spread of HIV and other
infectious diseases, such as hepatitis C.
From the analysis, they can simulate injection rate networks on a large
scale and develop long-term projections of HIV's spread.
"We can use these simulations to experiment with what kinds of
interventions might be effective in stopping HIV, given the risk networks and the way they develop," he said.
Throughout the study, they will evaluate the number of doctors willing
to treat AIDS patients and develop a transportation plan for participants who contract HIV to support their medical care.
"There are resources available," Dombrowski said. "The problem is that
people don't know about them. So we're going to facilitate what people already have available."
Using information from the social network evaluation, researchers will
launch a peer education program that trains injectors to talk to peers about HIV prevention and will evaluate the program's effectiveness.
"We feel strongly that this research will be useful outside of
Puerto Rico," Dombrowski said, referring to the increase in injection drug use in rural areas throughout the United States. "The
kind of risk behaviors that created HIV problems in big cities are growing in rural areas. Where you have risk behaviors
growing, HIV can't be too far behind."
NIH grant No.: R01 DA037117
Writer: Gillian Klucas, Research and Economic Development
News Release Contacts:
Kirk Dombrowski, Professor, Sociology
Source: University of Nebraska-Lincoln
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