Public Housing Relocations and Partnership Dynamics in Areas with High Prevalences of Sexually Transmitted Infections
BACKGROUND:
We
investigated the implications of one structural intervention-public housing
relocations-for partnership dynamics among individuals living areas with high
sexually transmitted infection (STI) prevalence. High-prevalence areas fuel STI
endemicity and are perpetuated by spatially assortative partnerships.
METHODS:
We
analyzed 7 waves of data from a cohort of black adults (n = 172) relocating
from 7 public housing complexes in Atlanta, Georgia. At each wave, data on
whether participants' sexual partners lived in the neighborhood were gathered
via survey. Participant addresses were geocoded to census tracts, and measures
of tract-level STI prevalence, socioeconomic conditions, and other attributes
were created for each wave. "High-prevalence tracts" were tracts in
the highest quartile of STI prevalence in Georgia. Descriptive statistics and
hierarchical generalized linear models examined trajectories of spatially
assortative partnerships and identified predictors of assortativity among
participants in high-prevalence tracts.
RESULTS:
All 7
tracts containing public housing complexes at baseline were high-prevalence
tracts; most participants relocated to high-prevalence tracts. Spatially
assortative partnerships had a U-shaped distribution: the mean percent of
partners living in participants' neighborhoods at baseline was 54%; this mean
declined to 28% at wave 2 and was 45% at wave 7. Participants who experienced
greater postrelocation improvements in tract-level socioeconomic conditions had
a lower odds of having spatially assortative partnerships (adjusted odds ratio,
1.55; 95% confidence interval [95% CI], 1.06-2.26).
CONCLUSIONS:
Public
housing relocation initiatives may disrupt high-prevalence areas if residents
experience significant postrelocation gains in tract-level socioeconomic
conditions.
- 1From the *Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, GA; †Division of General Medicine, Emory University School of Medicine, Atlanta, GA; ‡Institute of Public Health at Georgia State University, Atlanta, GA; §ZevRoss Spatial Analysis, Ithaca, New York;
- Department of Sociomedical Sciences, Columbia University School of Public Health, New York, NY; and ∥University of North Carolina Schools of Medicine and Gillings School of Global Public Health, Chapel Hill, NC.
- Sex Transm Dis. 2016 Apr;43(4):222-30. doi: 10.1097/OLQ.0000000000000419.
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