title: Effects of race, neighborhood, and social network on age at initiation of injection drug use.
abstract: OBJECTIVE
  We investigated individual- and neighborhood-level factors associated with adolescent initiation of injection drug use.
  
  
  METHODS
  Injection drug users (IDUs) who had been injecting 2 to 5 years underwent HIV testing and completed a sociobehavioral risk survey. Modeling techniques accounting for intraneighborhood correlations were used in data analyses.
  
  
  RESULTS
  Adolescent-initiating IDUs were less likely than adult-initiating IDUs to report high-risk sex and injection behaviors and more likely to report high-risk networks. African American IDUs from neighborhoods with large percentages of minority residents and low adult educational levels were more likely to initiate injection during adolescence than White IDUs from neighborhoods with low percentages of minority residents and high adult education levels.
  
  
  CONCLUSIONS
  Racial segregation and neighborhood-level educational attainment must be considered when drawing inferences about age at initiation of injection drug use and related high-risk behaviors.
authors.affiliation: Center for Infectious Disease Epidemiologic Research, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, 4th Floor, Room R422, New York, NY 10032, USA. cf317@columbia.edu
authors.forename: Crystal M
authors.initials: CM
authors.lastname: Fuller
authors.forename: Luisa N
authors.initials: LN
authors.lastname: Borrell
authors.forename: Carl A
authors.initials: CA
authors.lastname: Latkin
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
authors.forename: Danielle C
authors.initials: DC
authors.lastname: Ompad
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: David
authors.initials: D
authors.lastname: Vlahov
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D009519:New York City / Q000453:epidemiology; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D012309:Risk-Taking; D012931:Social Environment; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000208:ethnology*; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000208:ethnology* / Q000706:statistics & numerical data*