328240
Racial/ethnic differences in the association of social factors, health service density, and housing conditions with HIV risk behaviors among people who inject drugs in the US
Tuesday, November 3, 2015
Sabriya Linton, PhD, MPH,
Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, GA
Hannah LF Cooper, ScD, SM,
Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, GA
Mary Kelley, PhD,
Department of Biostatistics and Bioinformatics, Rollins School of Public Health at Emory University, Atlanta, GA
Conny Karnes, MA,
Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, GA
Mary Wolfe, MPH, CHES,
Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, GA
Zev Ross,
ZevRoss Spatial Analytics, Ithaca, NY
Don Des Jarlais, PhD,
The Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Salaam Semaan, DrPH,
National Center for HIV/AIDS, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Injection-related risk behavior (sharing syringes/other equipment) and sex without a condom are high among some people who inject drugs (PWID). This cross-sectional analysis assesses relationships of socioeconomic conditions, housing, and health service density to injection-related risk behavior and sex without a condom among PWID. PWID were recruited via respondent-driven sampling from 19 metropolitan statistical areas (MSAs) for the CDC’s 2009 National HIV Behavioral Surveillance. Injection-related risk behavior and sex without a condom were defined as separate dichotomous (any vs. none) outcomes. Place characteristics were selected according to prior literature, measured at ZIP codes, counties, and MSAs, and matched to ZIP codes, counties, and MSAs where participants lived. Logistic multilevel modeling was used; analyses were stratified by three participant racial/ethnic groups (black,white,Latino). When individual-level characteristics were adjusted for, ZIP code-level density of syringe exchange programs was protective against injection-related risk behavior among Latinos [AOR=0.59(CI=0.3,1.02)]; this association was borderline statistically significant. County-level unaffordable housing was associated with sex without a condom among blacks [AOR=6.8(CI=1.05,43.9)]. MSA-level black residential segregation was protective against injection-related risk behavior [AOR=0.16(CI=0.04,0.57)] and sex without a condom [AOR=0.40(CI=0.17,0.94)] among Latinos. Different place characteristics may be associated with risk behaviors among black and Latino PWID. The inverse association between black residential segregation and risk behaviors among Latino PWID corresponds with prior research, and may be explained by targeted HIV prevention services in predominantly black communities with high HIV prevalence. Future studies should investigate mechanisms behind the relationships observed in this analysis to inform HIV prevention strategies targeting specific racial/ethnic groups.
Learning Areas:
Diversity and culture
Epidemiology
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research
Social and behavioral sciences
Learning Objectives:
Assess the relationships of select place characteristics to the following HIV risk behaviors among people who inject drugs: (1) having sex without a condom and (2) sharing syringes/other equipment or using drugs divided by a shared syringe.
Keyword(s): HIV Risk Behavior, Drug Abuse
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am PI on the study and I helped with the analysis and creation of the abstract.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
