Department of Sociology, University of Nebraska-Lincoln, 206 Benton Hall, Lincoln, NE, 68588, USA.
Social Science Department, LaGuardia Community College, 29-10 Thompson Avenue, Long Island City, NY, 11101, USA.
BMC Public Health. 2019 Dec 19;19(1):1710. doi: 10.1186/s12889-019-8032-2.
While PWID of Puerto Rican origin have been migrating to the US for decades, the range of factors influencing their migration to the US and the resources they draw on to do so are not well understood. This is particularly true for rural Puerto Rican PWID, and the present study is the first empirical research to document migration patterns among this population. The specificities of their migration raise important challenges that need to be documented in order to implement more effective harm reduction policies at home (Puerto Rico) and abroad (US).
This paper draws from data obtained employing a modified NHBS survey which was administered to (N =296) PWID in four rural municipalities of Puerto Rico with participants 18 years or older. The primary dependent variables for this paper are the number of times a person has lived in the continental US, and if they are planning on moving to the continental US in the future.
Findings suggest that 65% of the sample reported ever lived in the US and that 49% are planning on moving in the future. The number of times living in the US is associated with higher education and older age, but not with self-reported positive HIV or HCV statuses. Planning to move to the US is associated with knowing PWID who have moved or plan to move, negatively associated with age, and is not associated with HIV or HCV status. Around one third of those that lived in the US reported having some sort of support, with the majority receiving support from family sources. No participant received help to enter HIV/HCV treatment.
A multi-region approach to prevention is required to make a dent in curbing HIV/HCV transmission in this population. Understanding PWID migration patterns, risk behaviors, and health care needs in the US is now more important than ever as natural disasters prompted by human-made climate change will only increase in the future, raising demands not only for service providers but also harm reduction policies to cope with an increasing influx of "climate refugees" as PWID move across national borders.
尽管波多黎各裔的 PWID 几十年来一直在向美国迁移，但影响他们向美国迁移的因素范围以及他们为此迁移所利用的资源还没有得到很好的理解。对于农村波多黎各的 PWID 来说尤其如此，而本研究是第一份记录这一人群迁移模式的实证研究。他们迁移的特殊性提出了一些重要的挑战，需要加以记录，以便在国内（波多黎各）和国外（美国）实施更有效的减少伤害政策。
本文利用对波多黎各四个农村市镇的（N=296）PWID 进行的一项经修改的 NHBS 调查数据，调查对象为 18 岁或以上的人员。本文的主要因变量是一个人在大陆生活的次数，以及他们未来是否计划迁往大陆。
研究结果表明，65%的样本报告曾在美国生活过，49%的人计划未来迁往美国。在美国生活的次数与较高的教育程度和较年长相关，但与自我报告的 HIV 或 HCV 阳性状况无关。计划迁往美国与认识已经迁移或计划迁移的 PWID 有关，与年龄呈负相关，与 HIV 或 HCV 状况无关。大约三分之一在美国生活过的人报告说得到了某种支持，其中大多数人从家庭获得支持。没有参与者得到帮助进入 HIV/HCV 治疗。
需要采取多区域办法，以遏制这一人群中 HIV/HCV 的传播。随着人为气候变化引发的自然灾害在未来只会增加，理解 PWID 在美国的迁移模式、风险行为和医疗保健需求比以往任何时候都更加重要，这不仅对服务提供者提出了要求，也对减少伤害政策提出了要求，以应对不断增加的“气候难民”涌入，因为 PWID 跨越国界迁移。
