Heroin use in Puerto Rico disproportionately affects people of lower incomes, especially in rural areas, and can lead to heightened rates of HIV among users, according to research by University of Nebraska-Lincoln’s Roberto Abadie.

Abadie, a research assistant professor in sociology at UNL, spoke to anthropology students on Monday, Oct. 7, in the Nebraska Union’s Chimney Rock room about his study on people who are addicted to heroin in the Puerto Rican countryside.

Abadie said the main anthropological angle examines the social aspect of doing heroin. According to Abadie, most users of heroin, especially those in Puerto Rico, use it in a group. This leads to a higher chance of them sharing needles and cookers, where the heroin is prepared, leading to more cases of HIV.

Most people in the study are using heroin not to get high but to avoid the immense pain of heroin withdrawal, Abadie said. People who are just trying to scrape by with little or no guaranteed income, or even a job, are essentially forced to spend up to $200 a day just to stave off the painful experience, he said.

According to Abadie, HIV can be transmitted not only sexually but also through the process of making and injecting heroin. He said HIV can be transmitted through the blood that is in or on the syringe and the water in what is referred to as the cooker. HIV can also be found in the cotton balls where they filter out the imperfections in the drug.

Abadie described what he calls a “shooting gallery.” According to Abadie, a shooting gallery is where people set up to inject heroin into whichever body part they can. He showed a picture of the skeleton of a sofa, retrofitted with a board through the middle that the users would use as a table to keep the equipment they use close by. In the photo, the floor is littered with small bags and green strips that were used to carry cocaine and heroin to the shooting gallery.

Abadie said he remembers an encounter with a man going through severe heroin withdrawal standing outside of his office in Cidra, Puerto Rico.

“[He was] feeling the pain in his bones, sweating and shivering,” Abadie said. “Eating anything solid would make him throw up … In his own words, he was sick. The only cure was another heroin shot.”

According to Abadie, the spread of HIV among users of heroin caused governments to begin heroin prevention programs and policies that would curb the spread of HIV among users of heroin.

Abadie said this study examined those living below the poverty line because they are more accessible. He said it would be harder to get Wall Street bankers to talk about drug use because they mostly use cocaine and heroin in drug-fueled parties.

The study was done over four years and studied people with HIV and hepatitis C, a liver infection that is transmitted through contaminated blood. Abadie found about 30% of the people using heroin also had either HIV or hepatitis C.

Abadie said reducing the social stigma of drug use can help users get the help they need and help prevent the spread of HIV. Many drug users are imprisoned before they can get treatment for any conditions they have, he said.

“This population [of drug users] is invisible and has been for a long time,” Abadie said. “It becomes very hard for politicians to argue for a minority population that is also really stigmatized and despised.”