title: HIV Infection Among People Who Inject Drugs in the United States: Geographically Explained Variance Across Racial and Ethnic Groups.
abstract: OBJECTIVE
  We explored how variance in HIV infection is distributed across multiple geographical scales among people who inject drugs (PWID) in the United States, overall and within racial/ethnic groups.
  
  
  METHODS
  People who inject drugs (n = 9077) were recruited via respondent-driven sampling from 19 metropolitan statistical areas (MSAs) for the Centers for Disease Control and Prevention's 2009 National HIV Behavioral Surveillance system. We used multilevel modeling to determine the percentage of variance in HIV infection explained by zip codes, counties, and MSAs where PWID lived, overall and for specific racial/ethnic groups.
  
  
  RESULTS
  Collectively, zip codes, counties, and MSAs explained 29% of variance in HIV infection. Within specific racial/ethnic groups, all 3 scales explained variance in HIV infection among non-Hispanic/Latino White PWID (4.3%, 0.2%, and 7.5%, respectively), MSAs explained variance among Hispanic/Latino PWID (10.1%), and counties explained variance among non-Hispanic/Latino Black PWID (6.9%).
  
  
  CONCLUSIONS
  Exposure to potential determinants of HIV infection at zip codes, counties, and MSAs may vary for different racial/ethnic groups of PWID, and may reveal opportunities to identify and ameliorate intraracial inequities in exposure to determinants of HIV infection at these geographical scales.
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Sabriya L
authors.initials: SL
authors.lastname: Linton
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Hannah L F
authors.initials: HL
authors.lastname: Cooper
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Kelley
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Conny C
authors.initials: CC
authors.lastname: Karnes
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Zev
authors.initials: Z
authors.lastname: Ross
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Wolfe
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Don
authors.initials: D
authors.lastname: Des Jarlais
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Salaam
authors.initials: S
authors.lastname: Semaan
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Barbara
authors.initials: B
authors.lastname: Tempalski
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: DiNenno
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Teresa
authors.initials: T
authors.lastname: Finlayson
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Catlainn
authors.initials: C
authors.lastname: Sionean
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Cyprian
authors.initials: C
authors.lastname: Wejnert
authors.affiliation: Sabriya L. Linton, Hannah L. F. Cooper, Mary E. Kelley, Conny C. Karnes, and Mary E. Wolfe are with The Rollins School of Public Health at Emory University, Atlanta, GA. Zev Ross is with ZevRoss SpatialAnalysis, Ithaca, NY. Don Des Jarlais is with The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Barbara Tempalski is with The Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY. Salaam Semaan, Elizabeth DiNenno, Teresa Finlayson, Catlainn Sionean, Cyprian Wejnert, and Gabriela Paz-Bailey are with the Centers for Disease Control and Prevention, Atlanta.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Paz-Bailey
mesh_terms: D000328:Adult; D044383:Black People / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D011159:Population Surveillance; D044469:Racial Groups / Q000706:statistics & numerical data*; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000208:ethnology*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American