Identifying Which Place Characteristics are Associated with the Odds of Recent HIV Testing in a Large Sample of People Who Inject Drugs in 19 US Metropolitan Areas
This exploratory analysis investigates relationships of place characteristics to HIV testing among people who inject drugs (PWID). We used CDC’s 2012 National HIV Behavioral Surveillance (NHBS) data among PWID from 19 US metropolitan statistical areas (MSAs); we restricted the analytic sample to PWID self-reporting being HIV negative (N = 7477). Administrative data were analyzed to describe the 1. Sociodemographic Composition; 2. Economic disadvantage; 3. Healthcare Service/Law enforcement; and 4. HIV burden of the ZIP codes, counties, and MSAs where PWID lived. Multilevel models tested associations of place characteristics with HIV testing. Fifty-eight percent of PWID reported past-year testing. MSA-level per capita correctional expenditures were positively associated with recent HIV testing among black PWID, but not white PWID. Higher MSA-level household income and imbalanced sex ratios (more women than men) in the MSA were associated with higher odds of testing. HIV screening for PWID is suboptimal (58%) and needs improvement. Identifying place characteristics associated with testing among PWID can strengthen service allocation and interventions in areas of need to increase access to HIV testing.
KeywordsPlace characteristics HIV testing People who inject drugs National HIV Behavioral Surveillance US metropolitan statistical areas
This research was supported by two Grants from the National Institutes of Health: “Place Characteristics & Disparities in HIV in IDUS: A Multilevel Analysis of NHBS” (DA035101; Cooper, PI) and, “Metropolitan Trajectories of HIV Epidemics and Responses in US Key Populations” (DA037568; Cooper, Friedman, & Stall, PIs). It was also supported by the Centers and Disease Control and Prevention, and the National HIV Behavioral Surveillance System Study Group: Atlanta, GA: Jennifer Taussig, Shacara Johnson, Jeff Todd; Baltimore, MD: Colin Flynn, Danielle German; Boston, MA: Debbie Isenberg, Maura Driscoll, Elizabeth Hurwitz; Chicago, IL: Nikhil Prachand, Nanette Benbow; Dallas, TX: Sharon Melville, Richard Yeager, Jim Dyer, Alicia Novoa; Denver, CO: Mark Thrun, Alia Al-Tayyib; Detroit, MI: Emily Higgins, Eve Mokotoff, Vivian Griffin; Houston, TX: Aaron Sayegh, Jan Risser, Hafeez Rehman; Los Angeles, CA: Trista Bingham, Ekow Kwa Sey; Miami, FL: Lisa Metsch, David Forrest, Dano Beck, Gabriel Cardenas; Nassau-Suffolk, NY: Chris Nemeth, Lou Smith, Carol-Ann Watson; New Orleans, LA: William T. Robinson, DeAnn Gruber, Narquis Barak; New York City, NY: Alan Neaigus, Samuel Jenness, Travis Wendel, Camila Gelpi-Acosta, Holly Hagan; Newark, NJ: Henry Godette, Barbara Bolden, Sally D’Errico; Philadelphia, PA: Kathleen A. Brady, Althea Kirkland, Mark Shpaner; San Diego, CA: Vanessa Miguelino-Keasling, Al Velasco; San Francisco, CA: H. Fisher Raymond; San Juan, PR: Sandra Miranda De Leo´n, Yadira Rolo´n-Colo´n; Seattle, WA: Maria Courogen, Hanne Thiede, Richard Burt; St Louis, MO: Michael Herbert, Yelena Friedberg, Dale Wrigley, Jacob Fisher; Washington, DC: Marie Sansone, Tiffany West-Ojo, Manya Magnus, Irene Kuo; Behavioral Surveillance Team. We also thank the men and women who participated in NHBS and the staff at all NHBS sites.
Compliance with Ethical Standards
Conflict of interest
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Each author has contributed to the conception and design of the work, the acquisition of data or the analysis of the data in a manner substantial enough to take public responsibility for it. In addition, each author believes that the paper represents valid work and has reviewed the final version of the manuscript and approves it for publication. The findings in this paper have not been published and are not being considered elsewhere for publication.
Emory University’s Institutional Review Board (IRB) approved this study’s protocols; each NHBS site’s IRB approved the NHBS protocol. CDC reviewed and approved the protocol as non-engaged research.
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