title: Risk Environments, Race/Ethnicity, and HIV Status in a Large Sample of People Who Inject Drugs in the United States.
abstract: BACKGROUND
  We analyzed relationships between place characteristics and being HIV-negative among black, Latino, and white people who inject drugs (PWID) in the US.
  
  
  METHODS
  Data on PWID (N = 9077) were from the Centers for Disease Control and Prevention's 2009 National HIV Behavioral Surveillance. Administrative data were analyzed to describe the 968 ZIP codes, 51 counties, and 19 metropolitan statistical areas (MSAs) where they lived. Multilevel multivariable models examined relationships between place characteristics and HIV status. Exploratory population attributable risk percents (e-PAR%s) were estimated.
  
  
  RESULTS
  Black and Latino PWID were more likely to be HIV-negative if they lived in less economically disadvantaged counties, or in MSAs with less criminal-justice activity (i.e., lower drug-related arrest rates, lower policing/corrections expenditures). Latino PWID were more likely to be HIV-negative in MSAs with more Latino isolation, less black isolation, and less violent crime. E-PAR%s attributed 8-19% of HIV cases among black PWID and 1-15% of cases among Latino PWID to place characteristics.
  
  
  CONCLUSIONS
  Evaluations of structural interventions to improve economic conditions and reduce drug-related criminal justice activity may show evidence that they protect black and Latino PWID from HIV infection.
authors.affiliation: Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States of America.
authors.forename: Hannah L F
authors.initials: HL
authors.lastname: Cooper
authors.affiliation: Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States of America.
authors.forename: Sabriya
authors.initials: S
authors.lastname: Linton
authors.affiliation: Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States of America.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Kelley
authors.affiliation: ZevRoss SpatialAnalysis, 120 N Aurora St, Suite 3A, Ithaca, NY 14850, United States of America.
authors.forename: Zev
authors.initials: Z
authors.lastname: Ross
authors.affiliation: Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States of America.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Wolfe
authors.affiliation: Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States of America.
authors.forename: Yen-Tyng
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States of America.
authors.forename: Maria
authors.initials: M
authors.lastname: Zlotorzynska
authors.affiliation: Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States of America.
authors.forename: Josalin
authors.initials: J
authors.lastname: Hunter-Jones
authors.affiliation: Institute for Infectious Disease Research, National Development and Research Institutes, 71 West 23rd Street, 4th Fl, New York, NY 10010, United States of America.
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Friedman
authors.affiliation: The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, 39 Broadway, 5th floor, New York, NY 10006, United States of America.
authors.forename: Don C
authors.initials: DC
authors.lastname: Des Jarlais
authors.affiliation: Institute for Infectious Disease Research, National Development and Research Institutes, 71 West 23rd Street, 4th Fl, New York, NY 10010, United States of America.
authors.forename: Barbara
authors.initials: B
authors.lastname: Tempalski
authors.affiliation: Centers for Disease Control and Prevention, 1600 Clifton Rd, NE (MS-E46), Atlanta, GA 30333, United States of America.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: DiNenno
authors.affiliation: Centers for Disease Control and Prevention, 1600 Clifton Rd, NE (MS-E46), Atlanta, GA 30333, United States of America.
authors.forename: Dita
authors.initials: D
authors.lastname: Broz
authors.affiliation: Centers for Disease Control and Prevention, 1600 Clifton Rd, NE (MS-E46), Atlanta, GA 30333, United States of America.
authors.forename: Cyprian
authors.initials: C
authors.lastname: Wejnert
authors.affiliation: Centers for Disease Control and Prevention, 1600 Clifton Rd, NE (MS-E46), Atlanta, GA 30333, United States of America.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Paz-Bailey
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology*; D001741:Black or African American; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D012307:Risk Factors; D012309:Risk-Taking; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States