Racialized risk environments in a large sample of people who inject drugs in the United States
Racialized risk environments in a large sample of people who inject drugs in the United States
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DOI：
10.1016/j.drugpo.2015.07.015
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发表时间：
2016-01-01
影响因子：
4.4
通讯作者：
Paz-Bailey, Gabriela
中科院分区：
文献类型：
--
作者：
Cooper, Hannah L. F.;Linton, Sabriya;Paz-Bailey, Gabriela
背景：许多国家注射吸毒者（PWID）的艾滋病毒感染存在巨大的种族/民族差异。为了加强努力了解艾滋病毒相关结果差异的原因并消除它们，我们扩展了“风险环境模型”以涵盖“种族化风险环境”的构建，并调查美国吸毒者风险环境是否种族化。具体来说，我们调查了黑人和拉丁裔注射吸毒者是否比白人注射吸毒者更有可能生活在容易受到艾滋病毒相关不良后果影响的地方。方法：作为疾病控制和预防中心国家艾滋病毒行为监测的一部分，2009 年从 19 个大都市统计区 (MSA) 抽取了 9170 名注射吸毒者。自我报告的数据用于确定注射吸毒者的种族/民族。利用人口普查数据和其他行政来源，我们描述了四个地理尺度（即邮政编码、县、MSA 和州）的吸毒者风险环境特征。计算了每个吸毒者种族/族裔群体的风险环境每个特征的平均值，并在不同种族/族裔群体之间进行了比较。结果：几乎所有测量结果都显示，黑人吸毒者比白人吸毒者更有可能生活在易受艾滋病毒相关不良后果影响的环境中。与白人注射吸毒者相比，黑人注射吸毒者生活在贫困率较高、获得药物滥用治疗的空间条件较差的邮政编码区以及暴力犯罪率较高的县。黑人注射吸毒者不太可能生活在有便利使用无菌注射器的法律（例如允许非处方注射器销售的法律）的州。在 MSA 层面，拉丁裔/白人在风险环境方面存在差异（例如，拉丁裔注射吸毒者生活在毒品相关逮捕率较高的 MSA）。结论：美国注射吸毒者的风险环境是种族化的。未来的研究应该使用适当的方法探讨这种种族化对艾滋病毒相关结果中种族/民族差异的影响。 (C) 2015 Elsevier B.V. 保留所有权利。
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. (C) 2015 Elsevier B.V. All rights reserved.