1
|
Linton SL, Cooper HLF, Kelley ME, Karnes CC, Ross Z, Wolfe ME, Chen YT, Friedman SR, Des Jarlais D, Semaan S, Tempalski B, Sionean C, DiNenno E, Wejnert C, Paz-Bailey G. Associations of place characteristics with HIV and HCV risk behaviors among racial/ethnic groups of people who inject drugs in the United States. Ann Epidemiol 2016; 26:619-630.e2. [PMID: 27576908 DOI: 10.1016/j.annepidem.2016.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 07/18/2016] [Accepted: 07/26/2016] [Indexed: 02/05/2023]
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.
Collapse
Affiliation(s)
- Sabriya L Linton
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA.
| | - Hannah L F Cooper
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Mary E Kelley
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Conny C Karnes
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Zev Ross
- ZevRoss Spatial Analysis, Ithaca, NY
| | - Mary E Wolfe
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Yen-Tyng Chen
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Samuel R Friedman
- Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY
| | - Don Des Jarlais
- Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY
| | - Salaam Semaan
- Centers for Disease Control and Prevention, Atlanta, GA
| | - Barbara Tempalski
- Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY
| | | | | | | | | | | |
Collapse
|