Integrating qualitative and quantitative methods: comparing HIV-related risk behaviors among Puerto Rican drug users in Puerto Rico and New York

A dual site project was conducted to assess determinants of injection and sex-related risk behaviors among Puerto Rican drug users. The project focused on injection drug users and crack smokers, and was conducted in East Harlem, NY and Bayamón, PR in 1996-2000. Qualitative methods included ethnographic mapping, focus groups, in-depth interviews, and observations. A survey component (East Harlem, n = 800; Bayamón, n = 400) was also conducted. Procedures to ensure integration of methodologies and comparability of data were developed. This paper describes the qualitative and survey methods used, and presents the comparative HIV risk behaviors. The integration of the two methodologies served multiple functions: each component identified issues to be addressed in the other, enhanced cross-site comparability of data, and assisted in interpretation of findings. The survey data showed high levels of risk behaviors in both communities, with significantly higher levels of risk reported in Bayamón. Conducting studies of similar ethnic groups in different communities provides opportunities to examine diverse sources of influence on risk behaviors. The integration of qualitative and quantitative methods can enhance comparability and understanding of findings, particularly when there are differences in behaviors between communities.

Trends in HIV seroprevalence and needle sharing among Puerto Rican drug injectors in Puerto Rico and New York: 1992-1999

This study assessed trends in HIV seroprevalence and needle-sharing behaviors among Puerto Rican injection drug users (IDUs) in Puerto Rico and New York. Data from two studies of IDUs conducted from 1992 through 1995 and 1998 through 1999 in Bayamón, Puerto Rico, and East Harlem, New York, were examined to assess trends over this period. Separate analyses were conducted for IDUs who were current crack smokers. Significant decreasing trends in seroprevalence were found among IDUs in the New York and Puerto Rico samples (p <.001). Significant decreasing trends in receptive and distributive needle sharing were found in the New York sample, and a significant decline in receptive sharing was found in the Puerto Rico sample. Overall, higher levels of needle-sharing behaviors were reported in Puerto Rico compared with New York. Decreasing trends in needle sharing and seroprevalence in both communities are an encouraging finding. 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.

Chronic renal failure in children: analysis of main causes and deterioration rate in 81 children

Cause of chronic renal failure (CRF), age at clinical onset, and deterioration rate were studied in 81 unselected children 2 months to 18 years old who were referred to UM-JMH during a six-year period. Obstructive uropathies caused 42%, glomerulopathies 27%, renal hypoplasias 15%, and hereditary and vascular nephropathies 8%. Age at clinical onset of CRF was significantly lower in patients with obstructive uropathies (2.8 years) and renal hypoplasias (2.4 years) than in glomerulopathies (10.7 years). Deterioration rate correlated with cause of CRF; it was more rapid in primary glomerulopathies (4.1 years) and renal hypoplasias (4.2 years) than in obstructive uropathies (6.7 years). Within the six-year period, half the patients studied reached end-stage renal disease (ESRD). Final outcome did not seem to be modified significantly by corrective procedures. These findings suggest that major efforts should be directed toward identification of the etiopathogenesis of congenital nephropathies to prevent occurrence of CRF.