Individual and Neighborhood Characteristics Associated with HIV Among Black and Latino Adults Who Use Drugs and Unaware of Their HIV-Positive Status, New York City, 2000-2004.
With mounting evidence of how neighborhood socioeconomic context influences individual behavior, investigation of neighborhood social context and sex/drug use risk behavior could help explain and provide insight into solutions to solve persistent racial disparities in HIV. Interviewer-administered surveys and HIV testing among street-recruited individuals who reported illicit drug use in New York City were conducted from 2000 to 2004. Individuals were geocoded to census tracts, and generalized estimating equations were used to determine correlates of being newly diagnosed with HIV at study enrollment. Analyses were completed in 2014. Of the 920 participants, 10.5 % were HIV-positive, and among those, 45 % were diagnosed at study enrollment. After restricting the sample to those who self-reported negative HIV status (n = 867), 72 % were male, 65 % Latino, and 5.1 % tested HIV-positive. After adjustment, those testing HIV-positive were more likely to report male same-sex partnership (p < 0.01) and less likely to be homeless compared with those confirmed HIV-negative (p < 0.01). Neighborhood-adjusted models indicated those from neighborhoods with less deprivation (p < 0.05), and a higher proportion of owner-occupied homes (p < 0.01) were more likely to test HIV-positive. Additionally, Black individuals who used drugs and were from neighborhoods with a higher proportion of Black residents were more likely to be newly diagnosed compared to Latino individuals who used drugs and were from neighborhoods with lower proportions of Black residents (p < 0.05). These data suggest that HIV prevention and treatment efforts should continue widening its reach to those unaware of their HIV infection, namely men who have sex with men, heavy, drug-involved Black communities, and both Black and Latino communities from relatively less disadvantaged neighborhoods.
Division of Social Solutions and Services Research, Nathan Kline Institute for Psychiatric Research, State of New York Office of Mental Health, 140 Orangeburg Road, Bldg. #35, N202, Orangeburg, NY, 10962, USA. clewis@nki.rfmh.org.|Department of Psychiatry, New York University School of Medicine, New York, NY, USA. clewis@nki.rfmh.org.
Crystal Fuller
CF
Lewis
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Alexis V
AV
Rivera
Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Natalie D
ND
Crawford
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Kirsha
K
Gordon
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Kellee
K
White
School of Nursing, University of California, San Francisco, CA, USA.
David
D
Vlahov
Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Sandro
S
Galea
D000328:Adult; D001741:Black or African American; D015658:HIV Infections / Q000208:ethnology* / Q000517:prevention & control; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D009519:New York City; D012111:Residence Characteristics; D000072339:Sexual and Gender Minorities; D019966:Substance-Related Disorders
HIV; Neighborhood context; Newly diagnosed; Persons who use drugs