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.
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.
Authors: Dustin T Duncan; Ichiro Kawachi; S V Subramanian; Jared Aldstadt; Steven J Melly; David R Williams Journal: Am J Epidemiol Date: 2013-10-22 Impact factor: 4.897
Authors: Caitlin Conrad; Heather M Bradley; Dita Broz; Swamy Buddha; Erika L Chapman; Romeo R Galang; Daniel Hillman; John Hon; Karen W Hoover; Monita R Patel; Andrea Perez; Philip J Peters; Pam Pontones; Jeremy C Roseberry; Michelle Sandoval; Jessica Shields; Jennifer Walthall; Dorothy Waterhouse; Paul J Weidle; Hsiu Wu; Joan M Duwve Journal: MMWR Morb Mortal Wkly Rep Date: 2015-05-01 Impact factor: 17.586
Authors: Xinzhi Zhang; Eliseo J Pérez-Stable; Philip E Bourne; Emmanuel Peprah; O Kenrik Duru; Nancy Breen; David Berrigan; Fred Wood; James S Jackson; David W S Wong; Joshua Denny Journal: Ethn Dis Date: 2017-04-20 Impact factor: 1.847