Racialized Risk Environments in a Large Sample of People Who Inject Drugs in the United States

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.

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).

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.

Via: http://ht.ly/S4R0R

By: Cooper HL1, Linton S2, Kelley ME2, Ross Z3, Wolfe ME2, Chen YT2, Zlotorzynska M2, Hunter-Jones J2, Friedman SR4, Des Jarlais D5, Semaan S6, Tempalski B4, DiNenno E6, Broz D6, Wejnert C6, Paz-Bailey G6; National HIV Behavioral Surveillance Study Group.

• 1Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA. Electronic address: hcoope3@emory.edu.
• 2Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
• 3ZevRoss SpatialAnalysis, 120 N Aurora St, Suite 3A, Ithaca, NY 14850, USA.
• 4Institute for Infectious Disease Research, National Development and Research Institutes, 71 West 23rd Street, 4th Fl, New York, NY 10010, USA.
• 5The Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, 160 Water Street, 24th floor, New York, NY 10038, USA.
• 6Centers for Disease Control and Prevention, Corporate Square Building 8, Atlanta, GA 30333, USA.