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

National HIV Behavioral Surveillance Study Group

Research output: Contribution to journalArticle

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

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Risk-Taking
Ethnic Groups
HIV
Pharmaceutical Preparations
Injections
Odds Ratio
Confidence Intervals
Sexual Behavior
Equipment and Supplies
Therapeutics

Keywords

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

ASJC Scopus subject areas

  • Epidemiology

Cite this

Associations of place characteristics with HIV and HCV risk behaviors among racial/ethnic groups of people who inject drugs in the United States. / National HIV Behavioral Surveillance Study Group.

In: Annals of Epidemiology, Vol. 26, No. 9, 01.09.2016, p. 619-630.e2.

Research output: Contribution to journalArticle

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title = "Associations of place characteristics with HIV and HCV risk behaviors among racial/ethnic groups of people who inject drugs in the United States",
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.",
keywords = "Condom use, Drug treatment, HCV, HIV, Housing, Injection drug use, PWID",
author = "{National HIV Behavioral Surveillance Study Group} and Sabriya Linton and Cooper, {Hannah L F} and Kelley, {Mary E.} and Karnes, {Conny C.} and Zev Ross and Wolfe, {Mary E.} and Chen, {Yen Tyng} and Friedman, {Samuel R.} and {Des Jarlais}, Don and Salaam Semaan and Barbara Tempalski and Catlainn Sionean and Elizabeth DiNenno and Cyprian Wejnert and Gabriela Paz-Bailey and Jennifer Taussig and Shacara Johnson and Jeff Todd and Colin Flynn and Danielle German and Debbie Isenberg and Maura Driscoll and Elizabeth Hurwitz and Nikhil Prachand and Nanette Benbow and Sharon Melville and Richard Yeager and Jim Dyer and Alicia Novoa and Mark Thrun and Alia Al-Tayyib and Emily Higgins and Eve Mokotoff and Vivian Griffin and Aaron Sayegh and Jan Risser and Hafeez Rehman and Trista Bingham and Sey, {Ekow Kwa} and Lisa Metsch and David Forrest and Dano Beck and Gabriel Cardenas and Chris Nemeth and Lou Smith and Watson, {Carol Ann} and Robinson, {William T.} and Gruber, {De Ann} and Narquis Barak and Alan Neaigus",
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AU - National HIV Behavioral Surveillance Study Group

AU - Linton, Sabriya

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AU - Kelley, Mary E.

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AU - Des Jarlais, Don

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AU - Tempalski, Barbara

AU - Sionean, Catlainn

AU - DiNenno, Elizabeth

AU - Wejnert, Cyprian

AU - Paz-Bailey, Gabriela

AU - Taussig, Jennifer

AU - Johnson, Shacara

AU - Todd, Jeff

AU - Flynn, Colin

AU - German, Danielle

AU - Isenberg, Debbie

AU - Driscoll, Maura

AU - Hurwitz, Elizabeth

AU - Prachand, Nikhil

AU - Benbow, Nanette

AU - Melville, Sharon

AU - Yeager, Richard

AU - Dyer, Jim

AU - Novoa, Alicia

AU - Thrun, Mark

AU - Al-Tayyib, Alia

AU - Higgins, Emily

AU - Mokotoff, Eve

AU - Griffin, Vivian

AU - Sayegh, Aaron

AU - Risser, Jan

AU - Rehman, Hafeez

AU - Bingham, Trista

AU - Sey, Ekow Kwa

AU - Metsch, Lisa

AU - Forrest, David

AU - Beck, Dano

AU - Cardenas, Gabriel

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AU - Smith, Lou

AU - Watson, Carol Ann

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AU - Barak, Narquis

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N2 - 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.

AB - 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.

KW - Condom use

KW - Drug treatment

KW - HCV

KW - HIV

KW - Housing

KW - Injection drug use

KW - PWID

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