Associations of place characteristics with HIV and HCV risk behaviors among racial/ethnic groups of people who inject drugs in the United States

Sabriya L. Linton*, Hannah L F Cooper, Mary E. Kelley, Conny C. Karnes, Zev Ross, Mary E. Wolfe, Yen Tyng Chen, Samuel R. Friedman, Don Des Jarlais, Salaam Semaan, Barbara Tempalski, Catlainn Sionean, Elizabeth DiNenno, Cyprian Wejnert, Gabriela Paz-Bailey, Jennifer Taussig, Shacara Johnson, Jeff Todd, Colin Flynn, Danielle GermanDebbie Isenberg, Maura Driscoll, Elizabeth Hurwitz, Nikhil Prachand, Nanette Benbow, Sharon Melville, Richard Yeager, Jim Dyer, Alicia Novoa, Mark Thrun, Alia Al-Tayyib, Emily Higgins, Eve Mokotoff, Vivian Griffin, Aaron Sayegh, Jan Risser, Hafeez Rehman, Trista Bingham, Ekow Kwa Sey, Lisa Metsch, David Forrest, Dano Beck, Gabriel Cardenas, Chris Nemeth, Lou Smith, Carol Ann Watson, William T. Robinson, De Ann Gruber, Narquis Barak, Alan Neaigus, National HIV Behavioral Surveillance Study Group

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)619-630.e2
JournalAnnals of Epidemiology
Volume26
Issue number9
DOIs
StatePublished - Sep 1 2016

Keywords

  • Condom use
  • Drug treatment
  • HCV
  • HIV
  • Housing
  • Injection drug use
  • PWID

ASJC Scopus subject areas

  • Epidemiology

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