Drug Users and HIV Risk in Guatemala City, Guatemala

• Author: Jane Bertrand,Laura Ponchick,John Hembling,Giovanni Melendez
• DOI: 10.1177/0022042619826073
• Date: 01 April 2019
• Published date: 01 April 2019
• Subject Matter: Articles

https://doi.org/10.1177/0022042619826073

Journal of Drug Issues

2019, Vol. 49(2) 296 –307

© The Author(s) 2019

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DOI: 10.1177/0022042619826073

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Article

Drug Users and HIV Risk in

Guatemala City, Guatemala

John Hembling1, Jane Bertrand1, Giovanni Melendez2,3,

and Laura Ponchick1

Abstract

Injection drug use is a known risk factor for HIV transmission, but research suggests non-injection

drug use also heightens HIV risk. This study measures HIV prevalence and examines sexual

behavior among drug users in Guatemala City. The multiplier method and respondent-driven

sampling (RDS) were used to estimate the size of the population, generating a representative

sample of 299 drug users 18+ years old living in Guatemala City. The study found that drug

users tended to be males with low education and income; 6% were HIV positive. Most drug

users reported sexual behaviors that heightened the risk of HIV transmission like multiple

sexual partners, buying or selling sex, low rates of consistent condom use, and exchanging

sex for drugs. HIV prevalence is low in Guatemala, but non-injection drug use likely increases

behaviors that heighten risk of HIV transmission.

Keywords

HIV, drug use, preferred drugs, injection drug use, non-injection drug use, sexual behavior,

AIDS, high-risk

Introduction

In Latin America and the Caribbean, nearly two thirds of new HIV cases are distributed among

several key populations: men who have sex with men (MSM; 30% of all new infections), clients

of sex workers (23%), sex workers (6%), transgender people (3%), and people who inject drugs

(PWID; 2%); the remaining 36% of new cases comprising the rest of the population (UNAIDS,

2016). Historically, drug use in Central America has involved non-injection drugs, and HIV pre-

vention programs have not targeted drug users. However, the dramatic increase in drug traffick-

ing via the Pan-American highway and other routes has drawn new attention to drug use—even

non-injection drug use—as a potential risk factor for HIV (Feilding & Ochoa, 2016).

The role of drug use in HIV transmission has centered primarily on the sharing of unclean

needles and other injection equipment (Degenhardt et al., 2016). However, a growing

literature—primarily from the United States—links non-injection drug use to increased risk for

1Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

2USAID Guatemala, Guatemala City, Guatemala

3Pan American Social Marketing Organization, Guatemala City, Guatemala

Corresponding Author:

Laura Ponchick, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public

Health and Tropical Medicine, 1440 Canal Street, Suite 1900, New Orleans, LA 70112, USA.

Email: lponchic@tulane.edu

826073JODXXX10.1177/0022042619826073Journal of Drug IssuesHembling et al.

research-article2019