Skip to main page content
U.S. flag

An official website of the United States government

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb;97(1):88-104.
doi: 10.1007/s11524-019-00405-w.

Mortgage Discrimination and Racial/Ethnic Concentration Are Associated with Same-Race/Ethnicity Partnering among People Who Inject Drugs in 19 US Cities

Affiliations

Mortgage Discrimination and Racial/Ethnic Concentration Are Associated with Same-Race/Ethnicity Partnering among People Who Inject Drugs in 19 US Cities

Sabriya L Linton et al. J Urban Health. 2020 Feb.

Abstract

Racial/ethnic homophily in sexual partnerships (partners share the same race/ethnicity) has been associated with racial/ethnic disparities in HIV. Structural racism may partly determine racial/ethnic homophily in sexual partnerships. This study estimated associations of racial/ethnic concentration and mortgage discrimination against Black and Latino residents with racial/ethnic homophily in sexual partnerships among 7847 people who inject drugs (PWID) recruited from 19 US cities to participate in CDC's National HIV Behavioral Surveillance. Racial/ethnic concentration was defined by two measures that respectively compared ZIP code-level concentrations of Black residents to White residents and Latino residents to White residents, using the Index of Concentration at the Extremes. Mortgage discrimination was defined by two measures that respectively compared county-level mortgage loan denial among Black applicants to White applicants and mortgage loan denial among Latino applicants to White applicants, with similar characteristics (e.g., income, loan amount). Multilevel logistic regression models were used to estimate associations. Interactions of race/ethnicity with measures of racial/ethnic concentration and mortgage discrimination were added to the final multivariable model and decomposed into race/ethnicity-specific estimates. In the final multivariable model, among Black PWID, living in ZIP codes with higher concentrations of Black vs. White residents and counties with higher mortgage discrimination against Black residents was associated with higher odds of homophily. Living in counties with higher mortgage discrimination against Latino residents was associated with lower odds of homophily among Black PWID. Among Latino PWID, living in ZIP codes with higher concentrations of Latino vs. White residents and counties with higher mortgage discrimination against Latino residents was associated with higher odds of homophily. Living in counties with higher mortgage discrimination against Black residents was associated with lower odds of homophily among Latino PWID. Among White PWID, living in ZIP codes with higher concentrations of Black or Latino residents vs. White residents was associated with lower odds of homophily, but living in counties with higher mortgage discrimination against Black residents was associated with higher odds of homophily. Racial/ethnic segregation may partly drive same race/ethnicity sexual partnering among PWID. Future empirical evidence linking these associations directly or indirectly (via place-level mediators) to HIV/STI transmission will determine how eliminating discriminatory housing policies impact HIV/STI transmission.

Keywords: Discrimination; HIV; People who inject drugs; Racial/ethnic disparities; Segregation; Sexual partnerships.

PubMed Disclaimer

Similar articles

Cited by

References

    1. Racial/ethnic disparities in diagnoses of HIV/AIDS--33 states, 2001-2004. . MMWR Morbidity Mortality Weekly Report, 2006. 55(5): p. 121-125. - PubMed
    1. Mitsch AJ, Hall HI, Babu AS. Trends in HIV infection among persons who inject drugs: United States and Puerto Rico, 2008–2013. Am J Public Health. 2016;106(12):2194–2201. - PMC - PubMed
    1. Wejnert C, Hess KL, Hall HI, van Handel M, Hayes D, Fulton P Jr, An Q, Koenig LJ, Prejean J, Valleroy LA. Vital signs: trends in HIV diagnoses, risk behaviors, and prevention among persons who inject drugs - United States. MMWR Morbidity Mortality Weekly Report. 2016;65(47):1336–1342. - PubMed
    1. Burnett JC, Broz D, Spiller MW, Wejnert C, Paz-Bailey G. HIV infection and HIV-associated behaviors among persons who inject drugs - 20 cities, United States, 2015. MMWR Morb Mortal Wkly Rep. 2018;67(1):23–28. - PMC - PubMed
    1. Hill MJ, Holt M, Hanscom B, Wang Z, Cardenas-Turanzas M, Latkin C. Gender and race as correlates of high risk sex behaviors among injection drug users at risk for HIV enrolled in the HPTN 037 study. Drug Alcohol Depend. 2018;183:267–274. - PMC - PubMed

Publication types

LinkOut - more resources