Racial/ethnic variations in the prevalence of human immunodeficiency virus type 1 infection among injecting drug users: Social and behavioral risk factors
Studies among injecting drug users (IDUs) often report higher prevalence of human immunodeficiency virus (HIV) infection for blacks and Puerto Ricans than for whites. Racial/ethnic differences in individual risk behaviors seldom explain the racial/ethnic disparity in HIV seroprevalence among IDUs. This study examines how individual risk behaviors and risk networks contribute to racial/ethnic variations in HIV seroprevalence among IDUs. Six hundred and sixty-two IDUs (175 blacks, 264 Puerto Ricans, 223 whites) were street-recruited in Bushwick, New York City, HIV tested, and interviewed about their risk behaviors and risk networks. Egocentric network measures were derived from self-reports, and sociometric network measures by graph-theoretic algebraic analysis of network linkages between study participants. Forty percent of IDUs were HIV-positive. The prevalence of HIV infection was greater for blacks (44%) and Puerto Ricans (45%) than for whites (32%). Social and risk networks of IDUs were mostly racially/ethnically homogeneous. In multivariate analysis, Puerto Rican race/ethnicity, individual risk behaviors, risk network contacts with older IDUs, risk network contacts with black IDUs, risk network contacts with Latino IDUs, and location in the Seidman 2-core of the sociometric network were independently associated with the likelihood of HIV seropositivity. Individual risk behaviors and risk networks statistically explain the higher HIV seroprevalence of blacks, but not that of Puerto Ricans. Risk networks (how and with whom IDUs are linked, and larger-scale patterns of linkages) of IDUs affect the likelihood of HIV seropositivity. Since HIV entered New York City minority IDU networks prior to white IDU networks, minority networks may be the reservoirs of infection. Therefore, the pattern of most risk partnerships being racially/ethnically homogeneous increases the likelihood of HIV infection among minority IDUs, but limits the chances for HIV transmission across racial/ethnic groups. Egocentric and sociometric networks explain some, but not all, of the racial/ethnic variations in HIV seroprevalence among IDUs. Epidemiological studies of HIV risk can be improved by incorporating temporal, spatial, and social network variables into behavioral models of HIV transmission. HIV prevention programs should extend their focus from individuals to social groups.
Demographics|Minority & ethnic groups|Sociology
Jose, Benny, "Racial/ethnic variations in the prevalence of human immunodeficiency virus type 1 infection among injecting drug users: Social and behavioral risk factors" (1996). ETD Collection for Fordham University. AAI9628335.