Racialized risk environments in a large sample of people who inject drugs in the United States

for the National HIV Behavioral Surveillance Study Group

doi:10.1016/j.drugpo.2015.07.015

Racialized risk environments in a large sample of people who inject drugs in the United States

for the National HIV Behavioral Surveillance Study Group

Mailman School of Public Health

Research output: Contribution to journal › Article › peer-review

54 Citations (Scopus)

Abstract

Background: Substantial racial/ethnic disparities exist in HIV infection among people who inject drugs (PWID) in many countries. To strengthen efforts to understand the causes of disparities in HIV-related outcomes and eliminate them, we expand the "Risk Environment Model" to encompass the construct "racialized risk environments," and investigate whether PWID risk environments in the United States are racialized. Specifically, we investigate whether black and Latino PWID are more likely than white PWID to live in places that create vulnerability to adverse HIV-related outcomes. Methods: As part of the Centers for Disease Control and Prevention's National HIV Behavioral Surveillance, 9170 PWID were sampled from 19 metropolitan statistical areas (MSAs) in 2009. Self-reported data were used to ascertain PWID race/ethnicity. Using Census data and other administrative sources, we characterized features of PWID risk environments at four geographic scales (i.e., ZIP codes, counties, MSAs, and states). Means for each feature of the risk environment were computed for each racial/ethnic group of PWID, and were compared across racial/ethnic groups. Results: Almost universally across measures, black PWID were more likely than white PWID to live in environments associated with vulnerability to adverse HIV-related outcomes. Compared to white PWID, black PWID lived in ZIP codes with higher poverty rates and worse spatial access to substance abuse treatment and in counties with higher violent crime rates. Black PWID were less likely to live in states with laws facilitating sterile syringe access (e.g., laws permitting over-the-counter syringe sales). Latino/white differences in risk environments emerged at the MSA level (e.g., Latino PWID lived in MSAs with higher drug-related arrest rates). Conclusion: PWID risk environments in the US are racialized. Future research should explore the implications of this racialization for racial/ethnic disparities in HIV-related outcomes, using appropriate methods.

Original language	English
Pages (from-to)	43-55
Number of pages	13
Journal	International Journal of Drug Policy
Volume	27
DOIs	https://doi.org/10.1016/j.drugpo.2015.07.015
Publication status	Published - Jan 1 2016

Bibliographical note

Publisher Copyright:
© 2015 Elsevier B.V.

Funding

This research was supported by two NIH grants: “ Place Characteristics & Disparities in HIV in IDUS: A Multilevel Analysis of NHBS ” ( DA035101 ; Cooper, PI) and the Emory Center for AIDS Research ( P30 AI050409 ; Curran, PI). It was also supported by the Centers and Disease Control and Prevention, and the National HIV Behavioral Surveillance Study Group: Atlanta, GA: Jennifer Taussig, Shacara Johnson, Jeff Todd; Baltimore, MD: Colin Flynn, Danielle German; Boston, MA: Debbie Isenberg, Maura Driscoll, Elizabeth Hurwitz; Chicago, IL: Nikhil Prachand, Nanette Benbow; Dallas, TX: Sharon Melville, Richard Yeager, Jim Dyer, Alicia Novoa; Denver, CO: Mark Thrun, Alia Al-Tayyib; Detroit, MI: Emily Higgins, Eve Mokotoff, Vivian Griffin; Houston, TX: Aaron Sayegh, Jan Risser, Hafeez Rehman; Los Angeles, CA: Trista Bingham, Ekow Kwa Sey; Miami, FL: Lisa Metsch, David Forrest, Dano Beck, Gabriel Cardenas; Nassau-Suffolk, NY: Chris Nemeth, Lou Smith, Carol-Ann Watson; New Orleans, LA: William T. Robinson, DeAnn Gruber, Narquis Barak; New York City, NY: Alan Neaigus, Samuel Jenness, Travis Wendel, Camila Gelpi-Acosta, Holly Hagan; Newark, NJ: Henry Godette, Barbara Bolden, Sally D’Errico; Philadelphia, PA: Kathleen A. Brady, Althea Kirkland, Mark Shpaner; San Diego, CA: Vanessa Miguelino-Keasling, Al Velasco; San Francisco, CA: H. Fisher Raymond; San Juan, PR: Sandra Miranda De León, Yadira Rolón-Colón; Seattle, WA: Maria Courogen, Hanne Thiede, Richard Burt; St Louis, MO: Michael Herbert, Yelena Friedberg, Dale Wrigley, Jacob Fisher; Washington, DC: Marie Sansone, Tiffany West-Ojo, Manya Magnus, Irene Kuo; Behavioral Surveillance Team. We would like to thank the NHBS participants for making this study possible. We also thank and acknowledge Mr. Scott Burris and Ms. Mona Bennett for their help documenting laws governing syringe access.

Funders	Funder number
Emory Center For AIDS Research	P30 AI050409
National HIV Behavioral Surveillance Study Group
National Institutes of Health
San Juan
Yadira Rolón-Colón
National Institutes of Health	P30DA011041, P30AI050409
National Institute on Drug Abuse	R01DA035101
Centers for Disease Control and Prevention

ASJC Scopus Subject Areas

Medicine (miscellaneous)
Health Policy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.drugpo.2015.07.015

Cite this

@article{6c27dbd424644a7784168f2308471f3c,

title = "Racialized risk environments in a large sample of people who inject drugs in the United States",

abstract = "Background: Substantial racial/ethnic disparities exist in HIV infection among people who inject drugs (PWID) in many countries. To strengthen efforts to understand the causes of disparities in HIV-related outcomes and eliminate them, we expand the {"}Risk Environment Model{"} to encompass the construct {"}racialized risk environments,{"} and investigate whether PWID risk environments in the United States are racialized. Specifically, we investigate whether black and Latino PWID are more likely than white PWID to live in places that create vulnerability to adverse HIV-related outcomes. Methods: As part of the Centers for Disease Control and Prevention's National HIV Behavioral Surveillance, 9170 PWID were sampled from 19 metropolitan statistical areas (MSAs) in 2009. Self-reported data were used to ascertain PWID race/ethnicity. Using Census data and other administrative sources, we characterized features of PWID risk environments at four geographic scales (i.e., ZIP codes, counties, MSAs, and states). Means for each feature of the risk environment were computed for each racial/ethnic group of PWID, and were compared across racial/ethnic groups. Results: Almost universally across measures, black PWID were more likely than white PWID to live in environments associated with vulnerability to adverse HIV-related outcomes. Compared to white PWID, black PWID lived in ZIP codes with higher poverty rates and worse spatial access to substance abuse treatment and in counties with higher violent crime rates. Black PWID were less likely to live in states with laws facilitating sterile syringe access (e.g., laws permitting over-the-counter syringe sales). Latino/white differences in risk environments emerged at the MSA level (e.g., Latino PWID lived in MSAs with higher drug-related arrest rates). Conclusion: PWID risk environments in the US are racialized. Future research should explore the implications of this racialization for racial/ethnic disparities in HIV-related outcomes, using appropriate methods.",

author = "{for the National HIV Behavioral Surveillance Study Group} and Cooper, {Hannah L.F.} and Sabriya Linton and Kelley, {Mary E.} and Zev Ross and Wolfe, {Mary E.} and Chen, {Yen Tyng} and Maria Zlotorzynska and Josalin Hunter-Jones and Friedman, {Samuel R.} and {Des Jarlais}, Don and Salaam Semaan and Barbara Tempalski and Elizabeth DiNenno and Dita Broz 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",

note = "Publisher Copyright: {\textcopyright} 2015 Elsevier B.V.",

year = "2016",

month = jan,

day = "1",

doi = "10.1016/j.drugpo.2015.07.015",

language = "English",

volume = "27",

pages = "43--55",

journal = "International Journal of Drug Policy",

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T1 - Racialized risk environments in a large sample of people who inject drugs in the United States

AU - for the National HIV Behavioral Surveillance Study Group

AU - Cooper, Hannah L.F.

AU - Linton, Sabriya

AU - Kelley, Mary E.

AU - Ross, Zev

AU - Wolfe, Mary E.

AU - Chen, Yen Tyng

AU - Zlotorzynska, Maria

AU - Hunter-Jones, Josalin

AU - Friedman, Samuel R.

AU - Des Jarlais, Don

AU - Semaan, Salaam

AU - Tempalski, Barbara

AU - DiNenno, Elizabeth

AU - Broz, Dita

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

AU - Nemeth, Chris

AU - Smith, Lou

AU - Watson, Carol Ann

AU - Robinson, William T.

AU - Gruber, De Ann

AU - Barak, Narquis

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background: Substantial racial/ethnic disparities exist in HIV infection among people who inject drugs (PWID) in many countries. To strengthen efforts to understand the causes of disparities in HIV-related outcomes and eliminate them, we expand the "Risk Environment Model" to encompass the construct "racialized risk environments," and investigate whether PWID risk environments in the United States are racialized. Specifically, we investigate whether black and Latino PWID are more likely than white PWID to live in places that create vulnerability to adverse HIV-related outcomes. Methods: As part of the Centers for Disease Control and Prevention's National HIV Behavioral Surveillance, 9170 PWID were sampled from 19 metropolitan statistical areas (MSAs) in 2009. Self-reported data were used to ascertain PWID race/ethnicity. Using Census data and other administrative sources, we characterized features of PWID risk environments at four geographic scales (i.e., ZIP codes, counties, MSAs, and states). Means for each feature of the risk environment were computed for each racial/ethnic group of PWID, and were compared across racial/ethnic groups. Results: Almost universally across measures, black PWID were more likely than white PWID to live in environments associated with vulnerability to adverse HIV-related outcomes. Compared to white PWID, black PWID lived in ZIP codes with higher poverty rates and worse spatial access to substance abuse treatment and in counties with higher violent crime rates. Black PWID were less likely to live in states with laws facilitating sterile syringe access (e.g., laws permitting over-the-counter syringe sales). Latino/white differences in risk environments emerged at the MSA level (e.g., Latino PWID lived in MSAs with higher drug-related arrest rates). Conclusion: PWID risk environments in the US are racialized. Future research should explore the implications of this racialization for racial/ethnic disparities in HIV-related outcomes, using appropriate methods.

AB - Background: Substantial racial/ethnic disparities exist in HIV infection among people who inject drugs (PWID) in many countries. To strengthen efforts to understand the causes of disparities in HIV-related outcomes and eliminate them, we expand the "Risk Environment Model" to encompass the construct "racialized risk environments," and investigate whether PWID risk environments in the United States are racialized. Specifically, we investigate whether black and Latino PWID are more likely than white PWID to live in places that create vulnerability to adverse HIV-related outcomes. Methods: As part of the Centers for Disease Control and Prevention's National HIV Behavioral Surveillance, 9170 PWID were sampled from 19 metropolitan statistical areas (MSAs) in 2009. Self-reported data were used to ascertain PWID race/ethnicity. Using Census data and other administrative sources, we characterized features of PWID risk environments at four geographic scales (i.e., ZIP codes, counties, MSAs, and states). Means for each feature of the risk environment were computed for each racial/ethnic group of PWID, and were compared across racial/ethnic groups. Results: Almost universally across measures, black PWID were more likely than white PWID to live in environments associated with vulnerability to adverse HIV-related outcomes. Compared to white PWID, black PWID lived in ZIP codes with higher poverty rates and worse spatial access to substance abuse treatment and in counties with higher violent crime rates. Black PWID were less likely to live in states with laws facilitating sterile syringe access (e.g., laws permitting over-the-counter syringe sales). Latino/white differences in risk environments emerged at the MSA level (e.g., Latino PWID lived in MSAs with higher drug-related arrest rates). Conclusion: PWID risk environments in the US are racialized. Future research should explore the implications of this racialization for racial/ethnic disparities in HIV-related outcomes, using appropriate methods.

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ER -

Racialized risk environments in a large sample of people who inject drugs in the United States

Abstract

Bibliographical note

Funding

ASJC Scopus Subject Areas

UN SDGs

Access to Document

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