Risk environments, race/ethnicity, and HIV status in a large sample of people who inject drugs in the United States

Hannah L F Cooper, Sabriya Linton, Mary E. Kelley, Zev Ross, Mary E. Wolfe, Yen Tyng Chen, Maria Zlotorzynska, Josalin Hunter-Jones, Samuel R. Friedman, Don C. Des Jarlais, Barbara Tempalski, Elizabeth DiNenno, Dita Broz, 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

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Introduction: We analyzed relationships between place characteristics and being HIV-negative among black, Latino, and white people who inject drugs (PWID) in the US. Methods: Data on PWID (N = 9077) were from the Centers for Disease Control and Prevention's 2009 National HIV Behavioral Surveillance. Administrative data were analyzed to describe the 968 ZIP codes, 51 counties, and 19 metropolitan statistical areas (MSAs) where they lived. Multilevel multivariable models examined relationships between place characteristics and HIV status. Exploratory population attributable risk percents (e-PAR %s) were estimated. Results: Black and Latino PWID were more likely tobe HIV-negative if they lived in less economically disadvantaged counties, or in MSAs with less criminal-justice activity (i.e., lower drug-related arrest rates, lower policing/corrections expenditures). Latino PWID were more likely to be HIV-negative in MSAs with more Latino isolation, less black isolation, and less violent crime. E-PAR%s attributed 8-19% of HIV cases among black PWID and 1-15% of cases among Latino PWID to place characteristics. Discussion: Evaluations of structural interventions to improve economic conditions and reduce drug-related criminal justice activity may show evidence that they protect black and Latino PWID from HIV infection.

Original languageEnglish (US)
Article numbere0150410
JournalPloS one
Issue number3
StatePublished - Mar 2016

ASJC Scopus subject areas

  • General


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