1. Associations of place characteristics with HIV and HCV risk behaviors among racial/ethnic groups of people who inject drugs in the United States
- Author
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Carol-Ann Watson, Al Velasco, Alia Al-Tayyib, Vivian Griffin, Travis Wendel, Kathleen A. Brady, Eve D. Mokotoff, Camila Gelpi-Acosta, Aaron Sayegh, Henry Godette, Marie Sansone, Trista Bingham, Alicia Novoa, Althea Kirkland, Don C. Des Jarlais, Sally D'Errico, Richard Yeager, Gabriel Cardenas, Shacara D. Johnson, Gabriela Paz-Bailey, H. Fisher Raymond, Michael Herbert, Sharon Melville, Manya Magnus, Jennifer Taussig, Lou C. Smith, Nanette Benbow, William T. Robinson, Hafeez Rehman, Elizabeth Hurwitz, Hanne Thiede, Irene Kuo, Barbara Bolden, Richard D. Burt, Cyprian Wejnert, Maura Driscoll, Hannah L.F. Cooper, Debbie Isenberg, Dano Beck, Sandra Miranda De Leo'n, Danielle German, Yen-Tyng Chen, Tiffany West-Ojo, David W. Forrest, Narquis Barak, Mary E. Wolfe, Ekow Kwa Sey, Catlainn Sionean, Mary E. Kelley, Chris Nemeth, Dale Wrigley, Samuel R. Friedman, DeAnn Gruber, Jeff Todd, Yelena Friedberg, Elizabeth DiNenno, Mark Thrun, Jim Dyer, Barbara Tempalski, Holly Hagan, Sabriya L. Linton, Jacob C. Fisher, Nikhil Prachand, Maria Courogen, Zev Ross, Conny Karnes, Alan Neaigus, Jan M. H. Risser, Mark Shpaner, Colin Flynn, Yadira Rolón-Colón, Vanessa Miguelino-Keasling, Salaam Semaan, Lisa R. Metsch, Samuel M. Jenness, and Emily Higgins
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Adult ,Male ,medicine.medical_specialty ,Epidemiology ,Sexual Behavior ,Ethnic group ,HIV Infections ,Risk Assessment ,Article ,Young Adult ,03 medical and health sciences ,Risk-Taking ,0302 clinical medicine ,Affordable housing ,Ethnicity ,medicine ,Humans ,030212 general & internal medicine ,Substance Abuse, Intravenous ,030505 public health ,Geography ,business.industry ,Incidence ,Racial Groups ,Multilevel model ,Odds ratio ,Hepatitis C, Chronic ,medicine.disease ,Health Surveys ,Metropolitan area ,United States ,Substance abuse ,Communicable Disease Control ,Female ,Residence ,Patient Safety ,0305 other medical science ,business ,Needs Assessment ,Demography - Abstract
Purpose Investigate whether characteristics of geographic areas are associated with condomless sex and injection-related risk behavior among racial/ethnic groups of people who inject drugs (PWID) in the United States. Methods PWID were recruited from 19 metropolitan statistical areas for 2009 National HIV Behavioral Surveillance. Administrative data described ZIP codes, counties, and metropolitan statistical areas where PWID lived. Multilevel models, stratified by racial/ethnic groups, were used to assess relationships of place-based characteristics to condomless sex and injection-related risk behavior (sharing injection equipment). Results Among black PWID, living in the South (vs. Northeast) was associated with injection-related risk behavior (adjusted odds ratio [AOR] = 2.24, 95% confidence interval [CI] = 1.21–4.17; P = .011), and living in counties with higher percentages of unaffordable rental housing was associated with condomless sex (AOR = 1.02, 95% CI = 1.00–1.04; P = .046). Among white PWID, living in ZIP codes with greater access to drug treatment was negatively associated with condomless sex (AOR = 0.93, 95% CI = 0.88–1.00; P = .038). Conclusions Policies that increase access to affordable housing and drug treatment may make environments more conducive to safe sexual behaviors among black and white PWID. Future research designed to longitudinally explore the association between residence in the south and injection-related risk behavior might identify specific place-based features that sustain patterns of injection-related risk behavior.
- Published
- 2016
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