Integrating Qualitative and Quantitative Methods: Comparing HIV-Related Risk Behaviors Among Puerto Rican Drug Users in Puerto Rico and New York

Abstract

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.

• Qualitative and quantitative methods
• Puerto Rican drug users
• Injection drug users (IDUs)
• Crack users

Resumen

El proyecto se condujo en dos sitios para determinar las conductas de riesgo relacionadas con inyección y sexo entre usuarios de droga de origen Puertorriqueño. El proyecto se enfoco en usuarios de droga inyectables y fumadores de crack (un derivado de la cocaína) y se condujo en el Este de Harlem, NY y Bayamón, PR en 1986–2000. Los métodos cualitativos, incluyeron cartografía etnográfica, grupos del foco, entrevista personales a fundo y observaciones. Entrevistas en forma de encuesta (Este de Harlem, n = 800; Bayamón, n = 400) fueron también realizadas. Procedimientos para asegurar que la integración de metodologías y compatibilidad de datos fueron desarrolladas. Este papel describe los métodos cualitativos y de encuesta que fueron usados y presenta las conductas relativas del riesgo al VIH. La integración de las dos metodologías sirvió múltiples funciones: cada componente identifica asuntos para ser analizados por el otro componente, elevo la compatibilidad de datos en ambos sitios, y ayudo en la interpretación de los hallazgos. Los datos de la encuesta mostraron niveles altos de conductas de riesgo en ambas comunidades, con niveles significativamente más altos del riesgo en Bayamón. Conducir estudios con grupos étnicos semejantes en comunidades diferentes proporciona oportunidades para examinar las diversas fuentes que influyen en las conductas de riesgo. La integración de métodos cualitativos y cuantitativos puede aumentar la compatibilidad y comprensión de hallazgos, particularmente cuando hay diferencias en conductas entre las comunidades.

Résumé

Un projet dans 2 sites a été conduit pour évaluer les causes déterminantes d’injection et de comportements de nature sexuelle de haut risque parmi des utilisateurs de drogue Porto Ricains. Le projet a mis l’emphase sur des utilisateurs de drogue d’injection et des fumeurs de crack, et a été conduit dans East Harlem (New York) et á Bayamon (Porto Rico) entre 1996–2000. Les méthodes qualitatives comprennent tracé éthnographique, groupes de discussion, entrevues personnelles détaillées et observations. Une enquête fut également conduite (Harlem, n = 800; Bayamon, n = 400). Des procédures pour assurer l’intégration des méthodes et al comparabilité des données ont été développées. Cet article décrit les methodes qualitatives et d’enquêtes utilisées et présente des donnees comparatives sur les comportement á haut risque pour the SIDA. L’intégration des deux méthodes a rempli des fonctions multiples: chacune a identifié des questions à adresser dans l’autre, mise en valeur la comparabilité des données entre les 2 sites et facilitité l’interprétation des résultats. Les données quantitatives indiquent de hauts niveaux de comportement de risque dans les deux communautés, avec des niveaux sensiblement plus élevés á Bayamon. La conduite d’études de groupes éthniques similaires dans communautés différentes donne la possibilite d’examiner des sources diverses d’influence sur des comportements de risque. L’intégration de méthodes qualitatives et quantitatives peut mettre en valeur la comparabilité et l’interpretation des résultats, en particulier quand il y a des différences de comportement entre les communautés.

Additional information

Notes on contributors

S. Deren

Sherry Deren, Ph.D., is Director of the Center for Drug Use and HIV Research (CDUHR) and the Institute for AIDS Research at National Development and Research Institutes, Inc. (NDRI). Her current research interests include expanding the uses of outreach methodologies, developing HIV/AIDS-related interventions for drug injectors and crack smokers, and enhancing the dissemination of research findings and their utilization by service providers.

D. Oliver-Velez

Denise Oliver-Velez is the Senior Research Associate/Ethnographer for the New York ARIBBA team. She has conducted research on AIDS and drug abuse for more than ten years. Her current interests include genealogy, social stratification, and rose growing.

A. Finlinson

Ann Finlinson, Ph.D., is an anthropologist who has worked for more than 12 years at the Center for Addiction Studies, School of Medicine, Universidad Central del Caribe in Bayamón, Puerto Rico. She is a member of a research team conducting studies on a wide range of topics related to drug abuse and HIV/AIDS on the island of Puerto Rico. Dr. Finlinson's published articles focus on syringe acquisition and use among Puerto Rican IDUs, the evaluation of needle exchange programs in Puerto Rico, and vaginal microbicide acceptability among drug-involved women in Puerto Rico.

R. Robles

Rafaela Robles, Ed.D., is a senior scientist and professor of the Universidad Central del Caribe, School of Medicine. She is also the Director of the Center for Addiction Studies and the Puerto Rico and U.S. Virgin Islands Addiction Technology Transfer Center. She has been conducting research on the HIV and drug addiction field in Puerto Rico for more than 12 years.

J. Andia

Jonny Andia, Ph.D., is the project director of a NIDA study examining determinants of HIV risk behaviors on Puerto Rican drug users in New York and Puerto Rico. He is also an adjunct assistant professor of Sociology at the John Jay College of Criminal Justice of the City University of New York. He is author and co-author of several articles focusing on substance use.

H. M. Colón

Hector M. Colón, Ph.D., has been conducting research on HIV and drug use in Puerto Rico for more than ten years. His interests span many topics related to drug use, including a focus on frequency of injection and HIV risk behaviors.

S.-Y. Kang

Sung Yeon Kang, Ph.D., has been involved in a wide variety of projects funded by the National Institute on Drug Abuse (NIDA). These projects have focused on drug abuse and related problems, such as criminal involvement, psychological status, HIV/AIDS, and other public health issues. Her numerous published articles include topics on criminal behaviors of drug abusers, evaluation of treatment, validity of self-reported drug use, HIV/AIDS risk behaviors, and drug use patterns among youth.

M. Shedlin

Michele Shedlin, Ph.D., is a medical anthropologist with extensive research and intervention experience in Latin America and the United States. She has designed and implemented behavioral research at the community, regional, and national levels, to inform and evaluate prevention and care programs. Her recent publications report results of research on sociocultural factors affecting HIV risk in El Salvador, Nicaragua, the Dominican Republic, and Latino immigrant groups in the United States.