title: Factors associated with drug treatment dropout among injection drug users in Puerto Rico.
abstract: This study examined factors associated with drug treatment dropout among injection drug users (IDUs) in Puerto Rico, a group that has contributed significantly to the self-sustaining AIDS epidemic in the island since the mid-1980s. A total of 557 IDUs were recruited from communities in a semirural region of Puerto Rico, as part of a longitudinal study testing the efficacy of a two-facet intervention model, based on motivational interviewing. Of 124 IDUs who had entered drug treatment at follow-up, 33 (26.6%) dropped out before completing all recommended sessions. Multiple logistic regression analysis showed that age, homelessness, and speedball use were significantly associated with drug treatment dropout. Conversely, participants who received the two-facet intervention were significantly less likely to drop out of drug treatment. Receiving psychiatric services also reduced the odds of treatment dropout. Improving adherence to drug treatment and reducing dropout rates are complex processes that need to be addressed at the individual behavioral and social support levels, as well as the program process and resource levels.
authors.affiliation: Center for Addiction Studies, Caribbean Basin and Hispanic Addiction Technology Transfer Center, School of Medicine, Universidad Central del Caribe, P.O. Box 60327, Bayamón 00960-6032, Puerto Rico. amarrero@uccaribe.edu
authors.forename: C Amalia
authors.initials: CA
authors.lastname: Marrero
authors.forename: Rafaela R
authors.initials: RR
authors.lastname: Robles
authors.forename: Héctor M
authors.initials: HM
authors.lastname: Colón
authors.forename: Juan C
authors.initials: JC
authors.lastname: Reyes
authors.forename: Tomás D
authors.initials: TD
authors.lastname: Matos
authors.forename: Hardeo
authors.initials: H
authors.lastname: Sahai
authors.forename: José M
authors.initials: JM
authors.lastname: Calderón
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Shepard
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006556:Heroin Dependence / Q000523:psychology / Q000534:rehabilitation; D006703:Ill-Housed Persons / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010342:Patient Acceptance of Health Care; D010352:Patient Dropouts / Q000523:psychology*; D011647:Puerto Rico / Q000453:epidemiology; D012423:Rural Health; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*