抵押贷款歧视和种族/民族集中与 19 个美国城市注射毒品者的同种族/民族伙伴关系有关。

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

机构信息

Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA.

Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA.

出版信息

J Urban Health. 2020 Feb;97(1):88-104. doi: 10.1007/s11524-019-00405-w.

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.

摘要

性伙伴关系中的种族/民族同质性(伙伴具有相同的种族/民族)与艾滋病毒的种族/民族差异有关。结构性种族主义可能在一定程度上决定了性伙伴关系中的种族/民族同质性。本研究估计了种族/民族集中和针对黑人和拉丁裔居民的抵押贷款歧视与 7847 名注射毒品者(PWID)的性伙伴关系中的种族/民族同质性之间的关联,这些人是从美国 19 个城市招募来参加疾病预防控制中心的全国艾滋病毒行为监测的。种族/民族集中程度由两个指标定义,分别是通过比较邮政编码级别的黑人和白人居民的集中程度,以及拉丁人和白人居民的集中程度,使用极端集中指数。抵押贷款歧视由两个指标定义,分别是比较县一级黑人和白人申请人的抵押贷款拒绝率,以及拉丁人和白人申请人的抵押贷款拒绝率,具有相似的特征(例如收入、贷款金额)。使用多水平逻辑回归模型来估计关联。种族/民族与种族/民族集中程度和抵押贷款歧视措施的相互作用被添加到最终的多变量模型中,并分解为种族/民族特异性估计值。在最终的多变量模型中,对于黑人 PWID,居住在黑人与白人居民集中程度较高的邮政编码区和抵押贷款歧视黑人居民程度较高的县,与同质性的几率较高相关。居住在抵押贷款歧视拉丁裔居民程度较高的县与黑人 PWID 的同质性几率较低相关。对于拉丁裔 PWID,居住在拉丁人和白人居民集中程度较高的邮政编码区和抵押贷款歧视拉丁裔居民程度较高的县,与同质性的几率较高相关。居住在抵押贷款歧视黑人居民程度较高的县与拉丁裔 PWID 的同质性几率较低相关。对于白人 PWID,居住在黑人或拉丁裔居民与白人居民集中程度较高的邮政编码区与同质性的几率较低相关,但居住在抵押贷款歧视黑人居民程度较高的县与同质性的几率较高相关。种族/民族隔离可能在一定程度上导致 PWID 之间的相同种族/民族性伴侣关系。未来将这些关联直接或间接地(通过地方层面的中介)联系起来的经验证据将确定消除歧视性住房政策如何影响艾滋病毒/性传播感染的传播。

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