Public Housing Relocations and Partnership Dynamics in Areas With High Prevalences of Sexually Transmitted Infections

• Type of Material: Article
• Authors: Hannah Cooper, Emory University; Loida Elena Bonney, Emory University; Ruiyan Luo, Georgia State University; Danielle F. Haley, Emory University; Sabriya L. Linton, Emory University; Josalin Hunter-Jones, Emory University; Zev Ross, ZevRoss Spatial Analysis; Gina M Wingood, Emory University; Adaora A. Adimora, University of North Carolina; Richard Rothenberg, Georgia State University
• Language: English
• Date: 2016-04-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 American Sexually Transmitted Diseases Association All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1097/OLQ.0000000000000419
• Title of Journal or Parent Work: Sexually Transmitted Diseases
• ISSN: 0148-5717
• Volume: 43
• Issue: 4
• Start Page: 222
• End Page: 230
• Grant/Funding Information: This study was supported by the following: a CFAR03 grant awarded by the Emory Center for AIDS Research (P30 AI050409), “Public Housing Relocations: Impact on Healthcare Access, Drug Use & Sexual Health” (R21DA027072), “Public Housing Relocations: Impact on HIV and Drug Use” (R01DA029513), the GSU Center for Excellence in the Study of Health Disparities (P20MD004806), a National Research Service Award (F31MH105238), and a George W Woodruff Fellowship from Emory University’s Laney Graduate School.
• Keywords: TRANSMISSION; Infectious Diseases; GEOGRAPHY; Science & Technology; DISEASE CORE; COHESION; PATTERNS; BALTIMORE; NEIGHBORHOODS; Life Sciences & Biomedicine; HIV RISK; GONORRHEA; AFTERMATH
• Research Categories: Psychology, Behavioral; Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Background: We investigated the implications of one structural intervention-public housing relocations-for partnership dynamics among individuals living areas with high sexually transmitted infection (STI) prevalence. High-prevalence areas fuel STI endemicity and are perpetuated by spatially assortative partnerships. Methods: We analyzed 7 waves of data from a cohort of black adults (n = 172) relocating from 7 public housing complexes in Atlanta, Georgia. At each wave, data on whether participants' sexual partners lived in the neighborhood were gathered via survey. Participant addresses were geocoded to census tracts, and measures of tract-level STI prevalence, socioeconomic conditions, and other attributes were created for each wave. "High-prevalence tracts" were tracts in the highest quartile of STI prevalence in Georgia. Descriptive statistics and hierarchical generalized linear models examined trajectories of spatially assortative partnerships and identified predictors of assortativity among participants in highprevalence tracts. Results: All 7 tracts containing public housing complexes at baseline were high-prevalence tracts; most participants relocated to high-prevalence tracts. Spatially assortative partnerships had a U-shaped distribution: the mean percent of partners living in participants' neighborhoods at baseline was 54%; this mean declined to 28% at wave 2 and was 45% at wave 7. Participants who experienced greater postrelocation improvements in tract-level socioeconomic conditions had a lower odds of having spatially assortative partnerships (adjusted odds ratio, 1.55; 95%confidence interval [95% CI], 1.06-2.26). Conclusions: Public housing relocation initiatives may disrupt highprevalence areas if residents experience significant postrelocation gains in tract-level socioeconomic conditions.