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. 2002;117(Suppl 1):S135–S145.

Social determinants and the health of drug users: socioeconomic status, homelessness, and incarceration.

Sandro Galea 1, David Vlahov 1
PMCID: PMC1913691  PMID: 12435837

Abstract

OBJECTIVES: This article reviews the evidence on the adverse health consequences of low socioeconomic status, homelessness, and incarceration among drug users. OBSERVATIONS: Social and economic factors shape risk behavior and the health of drug users. They affect health indirectly by shaping individual drug-use behavior; they affect health directly by affecting the availability of resources, access to social welfare systems, marginalization, and compliance with medication. Minority groups experience a disproportionately high level of the social factors that adversely affect health, factors that contribute to disparities in health among drug users. CONCLUSION: Public health interventions aimed at improving the health of drug users must address the social factors that accompany and exacerbate the health consequences of illicit drug use.

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Selected References

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  1. Adler N. E., Ostrove J. M. Socioeconomic status and health: what we know and what we don't. Ann N Y Acad Sci. 1999;896:3–15. doi: 10.1111/j.1749-6632.1999.tb08101.x. [DOI] [PubMed] [Google Scholar]
  2. Alcabes P., Vlahov D., Anthony J. C. Characteristics of intravenous drug users by history of arrest and treatment for drug use. J Nerv Ment Dis. 1992 Jan;180(1):48–54. doi: 10.1097/00005053-199201000-00010. [DOI] [PubMed] [Google Scholar]
  3. Anda R. F., Perlman S. B., D'Alessio D. J., Davis J. P., Dodson V. N. Hepatitis B in Wisconsin male prisoners: considerations for serologic screening and vaccination. Am J Public Health. 1985 Oct;75(10):1182–1185. doi: 10.2105/ajph.75.10.1182. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Andersen R., Bozzette S., Shapiro M., St Clair P., Morton S., Crystal S., Goldman D., Wenger N., Gifford A., Leibowitz A. Access of vulnerable groups to antiretroviral therapy among persons in care for HIV disease in the United States. HCSUS Consortium. HIV Cost and Services Utilization Study. Health Serv Res. 2000 Jun;35(2):389–416. [PMC free article] [PubMed] [Google Scholar]
  5. Barnett E., Casper M. A definition of "social environment". Am J Public Health. 2001 Mar;91(3):465–465. doi: 10.2105/ajph.91.3.465a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Barrow S. M., Herman D. B., Córdova P., Struening E. L. Mortality among homeless shelter residents in New York City. Am J Public Health. 1999 Apr;89(4):529–534. doi: 10.2105/ajph.89.4.529. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Battjes R. J., Pickens R. W., Haverkos H. W., Sloboda Z. HIV risk factors among injecting drug users in five US cities. AIDS. 1994 May;8(5):681–687. doi: 10.1097/00002030-199405000-00016. [DOI] [PubMed] [Google Scholar]
  8. Bond L., Semaan S. At risk for HIV infection: incarcerated women in a county jail in Philadelphia. Women Health. 1996;24(4):27–45. doi: 10.1300/j013v24n04_02. [DOI] [PubMed] [Google Scholar]
  9. Booth R. E., Kwiatkowski C. F., Chitwood D. D. Sex related HIV risk behaviors: differential risks among injection drug users, crack smokers, and injection drug users who smoke crack. Drug Alcohol Depend. 2000 Mar 1;58(3):219–226. doi: 10.1016/s0376-8716(99)00094-0. [DOI] [PubMed] [Google Scholar]
  10. Burman W. J., Cohn D. L., Rietmeijer C. A., Judson F. N., Sbarbaro J. A., Reves R. R. Noncompliance with directly observed therapy for tuberculosis. Epidemiology and effect on the outcome of treatment. Chest. 1997 May;111(5):1168–1173. doi: 10.1378/chest.111.5.1168. [DOI] [PubMed] [Google Scholar]
  11. Celentano D. D., Vlahov D., Cohn S., Shadle V. M., Obasanjo O., Moore R. D. Self-reported antiretroviral therapy in injection drug users. JAMA. 1998 Aug 12;280(6):544–546. doi: 10.1001/jama.280.6.544. [DOI] [PubMed] [Google Scholar]
  12. Chitwood D. D., McBride D. C., French M. T., Comerford M. Health care need and utilization: a preliminary comparison of injection drug users, other illicit drug users, and nonusers. Subst Use Misuse. 1999 Mar-Apr;34(4-5):727–746. doi: 10.3109/10826089909037240. [DOI] [PubMed] [Google Scholar]
  13. Curtis J. R., Patrick D. L., Caldwell E., Greenlee H., Collier A. C. The quality of patient-doctor communication about end-of-life care: a study of patients with advanced AIDS and their primary care clinicians. AIDS. 1999 Jun 18;13(9):1123–1131. doi: 10.1097/00002030-199906180-00017. [DOI] [PubMed] [Google Scholar]
  14. Davidson A. J., Bertram S. L., Lezotte D. C., Marine W. M., Rietmeijer C. A., Hagglund B. B., Cohn D. L. Comparison of health status, socioeconomic characteristics, and knowledge and use of HIV-related resources between HIV-infected women and men. Med Care. 1998 Dec;36(12):1676–1684. doi: 10.1097/00005650-199812000-00005. [DOI] [PubMed] [Google Scholar]
  15. Decker M. D., Vaughn W. K., Brodie J. S., Hutcheson R. H., Jr, Schaffner W. Seroepidemiology of hepatitis B in Tennessee prisoners. J Infect Dis. 1984 Sep;150(3):450–459. doi: 10.1093/infdis/150.3.450. [DOI] [PubMed] [Google Scholar]
  16. Decker M. D., Vaughn W. K., Brodie J. S., Hutcheson R. H., Jr, Schaffner W. The incidence of hepatitis B in Tennessee prisoners. J Infect Dis. 1985 Jul;152(1):214–217. doi: 10.1093/infdis/152.1.214. [DOI] [PubMed] [Google Scholar]
  17. Des Jarlais D. C. Structural interventions to reduce HIV transmission among injecting drug users. AIDS. 2000 Jun;14 (Suppl 1):S41–S46. doi: 10.1097/00002030-200006001-00006. [DOI] [PubMed] [Google Scholar]
  18. Diaz T., Chu S. Y., Buehler J. W., Boyd D., Checko P. J., Conti L., Davidson A. J., Hermann P., Herr M., Levy A. Socioeconomic differences among people with AIDS: results from a Multistate Surveillance Project. Am J Prev Med. 1994 Jul-Aug;10(4):217–222. [PubMed] [Google Scholar]
  19. Doherty M. C., Garfein R. S., Monterroso E., Latkin C., Vlahov D. Gender differences in the initiation of injection drug use among young adults. J Urban Health. 2000 Sep;77(3):396–414. doi: 10.1007/BF02386749. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Duncan G. J. Income dynamics and health. Int J Health Serv. 1996;26(3):419–444. doi: 10.2190/1KU0-4Y3K-ACFL-BYU7. [DOI] [PubMed] [Google Scholar]
  21. Edwards A., Curtis S., Sherrard J. Survey of risk behaviour and HIV prevalence in an English prison. Int J STD AIDS. 1999 Jul;10(7):464–466. doi: 10.1258/0956462991914474. [DOI] [PubMed] [Google Scholar]
  22. Ennett S. T., Federman E. B., Bailey S. L., Ringwalt C. L., Hubbard M. L. HIV-risk behaviors associated with homelessness characteristics in youth. J Adolesc Health. 1999 Nov;25(5):344–353. doi: 10.1016/s1054-139x(99)00043-9. [DOI] [PubMed] [Google Scholar]
  23. Friedman S. R., Chapman T. F., Perlis T. E., Rockwell R., Paone D., Sotheran J. L., Des Jarlais D. C. Similarities and differences by race/ethnicity in changes of HIV seroprevalence and related behaviors among drug injectors in New York City, 1991-1996. J Acquir Immune Defic Syndr. 1999 Sep 1;22(1):83–91. doi: 10.1097/00042560-199909010-00011. [DOI] [PubMed] [Google Scholar]
  24. Fullilove M. T. Root shock: the consequences of African American dispossession. J Urban Health. 2001 Mar;78(1):72–80. doi: 10.1093/jurban/78.1.72. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Fullilove M. T., Wiley J., Fullilove R. E., 3rd, Golden E., Catania J., Peterson J., Garrett K., Siegel D., Marin B., Kegeles S. Risk for AIDS in multiethnic neighborhoods in San Francisco, California. The population-based AMEN Study. West J Med. 1992 Jul;157(1):32–40. [PMC free article] [PubMed] [Google Scholar]
  26. Gallagher T. C., Andersen R. M., Koegel P., Gelberg L. Determinants of regular source of care among homeless adults in Los Angeles. Med Care. 1997 Aug;35(8):814–830. doi: 10.1097/00005650-199708000-00007. [DOI] [PubMed] [Google Scholar]
  27. Gawin F. H. Cocaine addiction: psychology and neurophysiology. Science. 1991 Mar 29;251(5001):1580–1586. doi: 10.1126/science.2011738. [DOI] [PubMed] [Google Scholar]
  28. Gelberg L., Leake B. D. Substance use among impoverished medical patients: the effect of housing status and other factors. Med Care. 1993 Sep;31(9):757–766. doi: 10.1097/00005650-199309000-00001. [DOI] [PubMed] [Google Scholar]
  29. Glaser J. B., Greifinger R. B. Correctional health care: a public health opportunity. Ann Intern Med. 1993 Jan 15;118(2):139–145. doi: 10.7326/0003-4819-118-2-199301150-00010. [DOI] [PubMed] [Google Scholar]
  30. Gleghorn A. A., Marx R., Vittinghoff E., Katz M. H. Association between drug use patterns and HIV risks among homeless, runaway, and street youth in northern California. Drug Alcohol Depend. 1998 Aug 1;51(3):219–227. doi: 10.1016/s0376-8716(98)00042-8. [DOI] [PubMed] [Google Scholar]
  31. Harding-Pink D. Mortality following release from prison. Med Sci Law. 1990 Jan;30(1):12–16. doi: 10.1177/002580249003000104. [DOI] [PubMed] [Google Scholar]
  32. Herman M., Galanter M., Lifshutz H. Combined substance abuse and psychiatric disorders in homeless and domiciled patients. Am J Drug Alcohol Abuse. 1991;17(4):415–422. doi: 10.3109/00952999109001600. [DOI] [PubMed] [Google Scholar]
  33. Horner R. D., Bennett C. L., Achenbach C., Rodriguez D., Adams J., Gilman S. C., Cohn S. E., Dickinson G. M., DeHovitz J. A., Weinstein R. A. Predictors of resource utilization for hospitalized patients with Pneumocystis carinii pneumonia (PCP): a summary of effects from the multi-city study of quality of PCP care. J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Aug 1;12(4):379–385. doi: 10.1097/00042560-199608010-00008. [DOI] [PubMed] [Google Scholar]
  34. Hull H. F., Lyons L. H., Mann J. M., Hadler S. C., Steece R., Skeels M. R. Incidence of hepatitis B in the penitentiary of New Mexico. Am J Public Health. 1985 Oct;75(10):1213–1214. doi: 10.2105/ajph.75.10.1213. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Johnson M. E., Fisher D. G., Davis D. C., Cagle H. H. Reading abilities of drug users in Anchorage, Alaska. J Drug Educ. 1995;25(1):73–80. doi: 10.2190/0314-YCWJ-LX7T-HWL3. [DOI] [PubMed] [Google Scholar]
  36. Johnson M. E., Fisher D. G., Davis D. C., Cagle H. H., Rhodes F., Booth R., Siegal H., Jones A. Assessing reading level of drug users for HIV and AIDS prevention purposes. AIDS Educ Prev. 1996 Aug;8(4):323–334. [PubMed] [Google Scholar]
  37. Koulierakis G., Gnardellis C., Agrafiotis D., Power K. G. HIV risk behaviour correlates among injecting drug users in Greek prisons. Addiction. 2000 Aug;95(8):1207–1216. doi: 10.1046/j.1360-0443.2000.95812077.x. [DOI] [PubMed] [Google Scholar]
  38. Krieger N. Embodying inequality: a review of concepts, measures, and methods for studying health consequences of discrimination. Int J Health Serv. 1999;29(2):295–352. doi: 10.2190/M11W-VWXE-KQM9-G97Q. [DOI] [PubMed] [Google Scholar]
  39. Lampinen T. M., Brewer A. M., Raba J. M. HIV in prison: a counseling opportunity. JAMA. 1991 Jul 17;266(3):361–361. doi: 10.1001/jama.266.3.361b. [DOI] [PubMed] [Google Scholar]
  40. Langford C. P., Bowsher J., Maloney J. P., Lillis P. P. Social support: a conceptual analysis. J Adv Nurs. 1997 Jan;25(1):95–100. doi: 10.1046/j.1365-2648.1997.1997025095.x. [DOI] [PubMed] [Google Scholar]
  41. Latkin C., Mandell W., Vlahov D., Oziemkowska M., Knowlton A., Celentano D. My place, your place, and no place: behavior settings as a risk factor for HIV-related injection practices of drug users in Baltimore, Maryland. Am J Community Psychol. 1994 Jun;22(3):415–430. doi: 10.1007/BF02506873. [DOI] [PubMed] [Google Scholar]
  42. Liberty H. J., Johnson B. D., Jainchill N., Ryder J., Messina M., Reynolds S., Hossain M. Dynamic Recovery: comparative study of therapeutic communities in homeless shelters for men. J Subst Abuse Treat. 1998 Sep-Oct;15(5):401–423. doi: 10.1016/s0740-5472(97)00287-0. [DOI] [PubMed] [Google Scholar]
  43. Link B. G., Phelan J. C. Understanding sociodemographic differences in health--the role of fundamental social causes. Am J Public Health. 1996 Apr;86(4):471–473. doi: 10.2105/ajph.86.4.471. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Link B. G., Susser E., Stueve A., Phelan J., Moore R. E., Struening E. Lifetime and five-year prevalence of homelessness in the United States. Am J Public Health. 1994 Dec;84(12):1907–1912. doi: 10.2105/ajph.84.12.1907. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Maantay J. Zoning, equity, and public health. Am J Public Health. 2001 Jul;91(7):1033–1041. doi: 10.2105/ajph.91.7.1033. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Magura S., Nwakeze P. C., Rosenblum A., Joseph H. Substance misuse and related infectious diseases in a soup kitchen population. Subst Use Misuse. 2000 Mar;35(4):551–583. doi: 10.3109/10826080009147472. [DOI] [PubMed] [Google Scholar]
  47. Mandell W., Kim J., Latkin C., Suh T. Depressive symptoms, drug network, and their synergistic effect on needle-sharing behavior among street injection drug users. Am J Drug Alcohol Abuse. 1999 Feb;25(1):117–127. doi: 10.1081/ada-100101849. [DOI] [PubMed] [Google Scholar]
  48. Marmot M. G., Shipley M. J., Rose G. Inequalities in death--specific explanations of a general pattern? Lancet. 1984 May 5;1(8384):1003–1006. doi: 10.1016/s0140-6736(84)92337-7. [DOI] [PubMed] [Google Scholar]
  49. Marzuk P. M., Tardiff K., Leon A. C., Hirsch C. S., Stajic M., Portera L., Hartwell N. Poverty and fatal accidental drug overdoses of cocaine and opiates in New York City: an ecological study. Am J Drug Alcohol Abuse. 1997 May;23(2):221–228. doi: 10.3109/00952999709040943. [DOI] [PubMed] [Google Scholar]
  50. McCarty D., Argeriou M., Huebner R. B., Lubran B. Alcoholism, drug abuse, and the homeless. Am Psychol. 1991 Nov;46(11):1139–1148. doi: 10.1037//0003-066x.46.11.1139. [DOI] [PubMed] [Google Scholar]
  51. McLachlan C., Crofts N., Wodak A., Crowe S. The effects of methadone on immune function among injecting drug users: a review. Addiction. 1993 Feb;88(2):257–263. doi: 10.1111/j.1360-0443.1993.tb00809.x. [DOI] [PubMed] [Google Scholar]
  52. Metsch L. R., McCoy C. B., McCoy H. V., Shultz J. M., Lai S., Weatherby N. L., McAnany H., Correa R., Anwyl R. S. HIV-related risk behaviors and seropositivity among homeless drug-abusing women in Miami, Florida. J Psychoactive Drugs. 1995 Oct-Dec;27(4):435–446. doi: 10.1080/02791072.1995.10471707. [DOI] [PubMed] [Google Scholar]
  53. Metsch L. R., McCoy C. B., McCoy H. V., Shultz J., Inciardi J., Wolfe H., Correa R. Social influences: living arrangements of drug using women at risk for HIV infection. Women Health. 1998;27(1-2):123–136. doi: 10.1300/J013v27n01_08. [DOI] [PubMed] [Google Scholar]
  54. Mor V., Fleishman J. A., Dresser M., Piette J. Variation in health service use among HIV-infected patients. Med Care. 1992 Jan;30(1):17–29. doi: 10.1097/00005650-199201000-00002. [DOI] [PubMed] [Google Scholar]
  55. Mäkelä P. Alcohol-related mortality as a function of socio-economic status. Addiction. 1999 Jun;94(6):867–886. doi: 10.1046/j.1360-0443.1999.94686710.x. [DOI] [PubMed] [Google Scholar]
  56. Needle R. H., Coyle S., Cesari H., Trotter R., Clatts M., Koester S., Price L., McLellan E., Finlinson A., Bluthenthal R. N. HIV risk behaviors associated with the injection process: multiperson use of drug injection equipment and paraphernalia in injection drug user networks. Subst Use Misuse. 1998 Oct;33(12):2403–2423. doi: 10.3109/10826089809059332. [DOI] [PubMed] [Google Scholar]
  57. Nuttbrock L., Rosenblum A., Magura S., McQuistion H. L., Joseph H. The association between cocaine use and HIV/STDs among soup kitchen attendees in New York City. J Acquir Immune Defic Syndr. 2000 Sep 1;25(1):86–91. doi: 10.1097/00042560-200009010-00012. [DOI] [PubMed] [Google Scholar]
  58. Obot I. S., Anthony J. C. Association of school dropout with recent and past injecting drug use among African American adults. Addict Behav. 1999 Sep-Oct;24(5):701–705. doi: 10.1016/s0306-4603(98)00117-8. [DOI] [PubMed] [Google Scholar]
  59. Obot I. S., Hubbard S., Anthony J. C. Level of education and injecting drug use among African Americans. Drug Alcohol Depend. 1999 Jun 1;55(1-2):177–182. doi: 10.1016/s0376-8716(98)00168-9. [DOI] [PubMed] [Google Scholar]
  60. Pablos-Méndez A., Knirsch C. A., Barr R. G., Lerner B. H., Frieden T. R. Nonadherence in tuberculosis treatment: predictors and consequences in New York City. Am J Med. 1997 Feb;102(2):164–170. doi: 10.1016/s0002-9343(96)00402-0. [DOI] [PubMed] [Google Scholar]
  61. Palepu A., Strathdee S. A., Hogg R. S., Anis A. H., Rae S., Cornelisse P. G., Patrick D. M., O'Shaughnessy M. V., Schechter M. T. The social determinants of emergency department and hospital use by injection drug users in Canada. J Urban Health. 1999 Dec;76(4):409–418. doi: 10.1007/BF02351499. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Pont J., Strutz H., Kahl W., Salzner G. HIV epidemiology and risk behavior promoting HIV transmission in Austrian prisons. Eur J Epidemiol. 1994 Jun;10(3):285–289. doi: 10.1007/BF01719351. [DOI] [PubMed] [Google Scholar]
  63. Rahav M., Nuttbrock L., Rivera J. J., Link B. G. HIV infection risks among homeless, mentally ill, chemical misusing men. Subst Use Misuse. 1998 May;33(6):1407–1426. doi: 10.3109/10826089809062224. [DOI] [PubMed] [Google Scholar]
  64. Rapiti E., Porta D., Forastiere F., Fusco D., Perucci C. A. Socioeconomic status and survival of persons with AIDS before and after the introduction of highly active antiretroviral therapy. Lazio AIDS Surveillance Collaborative Group. Epidemiology. 2000 Sep;11(5):496–501. doi: 10.1097/00001648-200009000-00003. [DOI] [PubMed] [Google Scholar]
  65. Rasmussen K. The role of the locus coeruleus and N-methyl-D-aspartic acid (NMDA) and AMPA receptors in opiate withdrawal. Neuropsychopharmacology. 1995 Dec;13(4):295–300. doi: 10.1016/0893-133X(95)00082-O. [DOI] [PubMed] [Google Scholar]
  66. Reindollar R. W. Hepatitis C and the correctional population. Am J Med. 1999 Dec 27;107(6B):100S–103S. doi: 10.1016/s0002-9343(99)00394-0. [DOI] [PubMed] [Google Scholar]
  67. Rich J. D., Strong L., Towe C. W., McKenzie M. Obstacles to needle exchange participation in Rhode Island. J Acquir Immune Defic Syndr. 1999 Aug 15;21(5):396–400. [PubMed] [Google Scholar]
  68. Robles R. R., Colón H. M., Matos T. D., Marrero C. A., López C. M. AIDS risk behavior patterns among intravenous drug users in Puerto Rico and the United States. Bol Asoc Med P R. 1990 Dec;82(12):523–527. [PubMed] [Google Scholar]
  69. Ruiz J. D., Molitor F., Sun R. K., Mikanda J., Facer M., Colford J. M., Jr, Rutherford G. W., Ascher M. S. Prevalence and correlates of hepatitis C virus infection among inmates entering the California correctional system. West J Med. 1999 Mar;170(3):156–160. [PMC free article] [PubMed] [Google Scholar]
  70. Sambamoorthi U., Warner L. A., Crystal S., Walkup J. Drug abuse, methadone treatment, and health services use among injection drug users with AIDS. Drug Alcohol Depend. 2000 Jul 1;60(1):77–89. doi: 10.1016/s0376-8716(99)00142-8. [DOI] [PubMed] [Google Scholar]
  71. Schoenbaum E. E., Hartel D., Selwyn P. A., Klein R. S., Davenny K., Rogers M., Feiner C., Friedland G. Risk factors for human immunodeficiency virus infection in intravenous drug users. N Engl J Med. 1989 Sep 28;321(13):874–879. doi: 10.1056/NEJM198909283211306. [DOI] [PubMed] [Google Scholar]
  72. Schumacher J. E., Milby J. B., Caldwell E., Raczynski J., Engle M., Michael M., Carr J. Treatment outcome as a function of treatment attendance with homeless persons abusing cocaine. J Addict Dis. 1995;14(4):73–85. doi: 10.1300/j069v14n04_05. [DOI] [PubMed] [Google Scholar]
  73. Shah N. G., Celentano D. D., Vlahov D., Stambolis V., Johnson L., Nelson K. E., Strathdee S. A. Correlates of enrollment in methadone maintenance treatment programs differ by HIV-serostatus. AIDS. 2000 Sep 8;14(13):2035–2043. doi: 10.1097/00002030-200009080-00020. [DOI] [PubMed] [Google Scholar]
  74. Shlay J. C., Blackburn D., O'Keefe K., Raevsky C., Evans M., Cohn D. L. Human immunodeficiency virus seroprevalence and risk assessment of a homeless population in Denver. Sex Transm Dis. 1996 Jul-Aug;23(4):304–311. doi: 10.1097/00007435-199607000-00011. [DOI] [PubMed] [Google Scholar]
  75. Siegal H. A., Carlson R. G., Falck R., Li L., Forney M. A., Rapp R. C., Baumgartner K., Myers W., Nelson M. HIV infection and risk behaviors among intravenous drug users in low seroprevalence areas in the Midwest. Am J Public Health. 1991 Dec;81(12):1642–1644. doi: 10.2105/ajph.81.12.1642. [DOI] [PMC free article] [PubMed] [Google Scholar]
  76. Siegal H. A., Carlson R. G., Wang J., Falck R. S., Stephens R. C., Nelson E. D. Injection drug users in the Midwest: an epidemiologic comparison of drug use patterns in four Ohio cities. J Psychoactive Drugs. 1994 Jul-Sep;26(3):265–275. doi: 10.1080/02791072.1994.10472440. [DOI] [PubMed] [Google Scholar]
  77. Singer M., Himmelgreen D., Dushay R., Weeks M. R. Variation in drug injection frequency among out-of-treatment drug users in a national sample. Am J Drug Alcohol Abuse. 1998 May;24(2):321–341. doi: 10.3109/00952999809001715. [DOI] [PubMed] [Google Scholar]
  78. Sleegers J. Similarities and differences in homelessness in Amsterdam and New York City. Psychiatr Serv. 2000 Jan;51(1):100–104. doi: 10.1176/ps.51.1.100. [DOI] [PubMed] [Google Scholar]
  79. Solomon L., Frank R., Vlahov D., Astemborski J. Utilization of health services in a cohort of intravenous drug users with known HIV-1 serostatus. Am J Public Health. 1991 Oct;81(10):1285–1290. doi: 10.2105/ajph.81.10.1285. [DOI] [PMC free article] [PubMed] [Google Scholar]
  80. Solomon L., Stein M., Flynn C., Schuman P., Schoenbaum E., Moore J., Holmberg S., Graham N. M. Health services use by urban women with or at risk for HIV-1 infection: the HIV Epidemiology Research Study (HERS). J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Mar 1;17(3):253–261. doi: 10.1097/00042560-199803010-00011. [DOI] [PubMed] [Google Scholar]
  81. Song J. Y., Safaeian M., Strathdee S. A., Vlahov D., Celentano D. D. The prevalence of homelessness among injection drug users with and without HIV infection. J Urban Health. 2000 Dec;77(4):678–687. doi: 10.1007/BF02344031. [DOI] [PMC free article] [PubMed] [Google Scholar]
  82. Spinner G. F., Leaf P. J. Homelessness and drug abuse in New Haven. Hosp Community Psychiatry. 1992 Feb;43(2):166–168. doi: 10.1176/ps.43.2.166. [DOI] [PubMed] [Google Scholar]
  83. Strathdee S. A., Palepu A., Cornelisse P. G., Yip B., O'Shaughnessy M. V., Montaner J. S., Schechter M. T., Hogg R. S. Barriers to use of free antiretroviral therapy in injection drug users. JAMA. 1998 Aug 12;280(6):547–549. doi: 10.1001/jama.280.6.547. [DOI] [PubMed] [Google Scholar]
  84. Susser E., Miller M., Valencia E., Colson P., Roche B., Conover S. Injection drug use and risk of HIV transmission among homeless men with mental illness. Am J Psychiatry. 1996 Jun;153(6):794–798. doi: 10.1176/ajp.153.6.794. [DOI] [PubMed] [Google Scholar]
  85. Susser E., Moore R., Link B. Risk factors for homelessness. Epidemiol Rev. 1993;15(2):546–556. doi: 10.1093/oxfordjournals.epirev.a036133. [DOI] [PubMed] [Google Scholar]
  86. Susser M., Susser E. Choosing a future for epidemiology: II. From black box to Chinese boxes and eco-epidemiology. Am J Public Health. 1996 May;86(5):674–677. doi: 10.2105/ajph.86.5.674. [DOI] [PMC free article] [PubMed] [Google Scholar]
  87. Tardiff K., Marzuk P. M., Leon A. C., Hirsch C. S., Stajic M., Portera L., Hartwell N. Homicide in New York City. Cocaine use and firearms. JAMA. 1994 Jul 6;272(1):43–46. [PubMed] [Google Scholar]
  88. Tardiff K., Marzuk P. M., Leon A. C., Hirsch C. S., Stajić M., Portera L., Hartwell N. Cocaine, opiates, and ethanol in homicides in New York City: 1990 and 1991. J Forensic Sci. 1995 May;40(3):387–390. [PubMed] [Google Scholar]
  89. Tomas J. M., Vlahov D., Anthony J. C. Association between intravenous drug use and early misbehavior. Drug Alcohol Depend. 1990 Feb;25(1):79–89. doi: 10.1016/0376-8716(90)90145-5. [DOI] [PubMed] [Google Scholar]
  90. Torres R. A., Mani S., Altholz J., Brickner P. W. Human immunodeficiency virus infection among homeless men in a New York City shelter. Association with Mycobacterium tuberculosis infection. Arch Intern Med. 1990 Oct;150(10):2030–2036. [PubMed] [Google Scholar]
  91. Villano S. A., Nelson K. E., Vlahov D., Purcell R. H., Saah A. J., Thomas D. L. Hepatitis A among homosexual men and injection drug users: more evidence for vaccination. Clin Infect Dis. 1997 Sep;25(3):726–728. doi: 10.1086/513757. [DOI] [PubMed] [Google Scholar]
  92. Vlahov D., Brewer F., Muñoz A., Hall D., Taylor E., Polk B. F. Temporal trends of human immunodeficiency virus type 1 (HIV-1) infection among inmates entering a statewide prison system, 1985-1987. J Acquir Immune Defic Syndr. 1989;2(3):283–290. [PubMed] [Google Scholar]
  93. Weeks M. R., Grier M., Romero-Daza N., Puglisi-Vasquez M. J., Singer M. Streets, drugs, and the economy of sex in the age of AIDS. Women Health. 1998;27(1-2):205–229. doi: 10.1300/J013v27n01_13. [DOI] [PubMed] [Google Scholar]
  94. Weisfuse I. B., Greenberg B. L., Back S. D., Makki H. A., Thomas P., Rooney W. C., Rautenberg E. L. HIV-1 infection among New York City inmates. AIDS. 1991 Sep;5(9):1133–1138. doi: 10.1097/00002030-199109000-00013. [DOI] [PubMed] [Google Scholar]
  95. Williams D. R. Race, socioeconomic status, and health. The added effects of racism and discrimination. Ann N Y Acad Sci. 1999;896:173–188. doi: 10.1111/j.1749-6632.1999.tb08114.x. [DOI] [PubMed] [Google Scholar]
  96. Williams M., Bowen A., Ross M., Freeman R., Elwood W. Perceived compliance with AZT dosing among a sample of African-American drug users. Int J STD AIDS. 2000 Jan;11(1):57–63. doi: 10.1258/0956462001914797. [DOI] [PubMed] [Google Scholar]
  97. Wohl A. R., Johnson D., Jordan W., Lu S., Beall G., Currier J., Kerndt P. R. High-risk behaviors during incarceration in African-American men treated for HIV at three Los Angeles public medical centers. J Acquir Immune Defic Syndr. 2000 Aug 1;24(4):386–392. doi: 10.1097/00126334-200008010-00014. [DOI] [PubMed] [Google Scholar]
  98. Wohl A. R., Johnson D., Jordan W., Lu S., Beall G., Currier J., Kerndt P. R. High-risk behaviors during incarceration in African-American men treated for HIV at three Los Angeles public medical centers. J Acquir Immune Defic Syndr. 2000 Aug 1;24(4):386–392. doi: 10.1097/00126334-200008010-00014. [DOI] [PubMed] [Google Scholar]
  99. Wolfe H., Marmor M., Maslansky R., Nichols S., Simberkoff M., Des Jarlais D., Moss A. Tuberculosis knowledge among New York City injection drug users. Am J Public Health. 1995 Jul;85(7):985–988. doi: 10.2105/ajph.85.7.985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  100. Worth D. Sexual decision-making and AIDS: why condom promotion among vulnerable women is likely to fail. Stud Fam Plann. 1989 Nov-Dec;20(6 Pt 1):297–307. [PubMed] [Google Scholar]
  101. Zierler S., Krieger N., Tang Y., Coady W., Siegfried E., DeMaria A., Auerbach J. Economic deprivation and AIDS incidence in Massachusetts. Am J Public Health. 2000 Jul;90(7):1064–1073. doi: 10.2105/ajph.90.7.1064. [DOI] [PMC free article] [PubMed] [Google Scholar]
  102. Zolopa A. R., Hahn J. A., Gorter R., Miranda J., Wlodarczyk D., Peterson J., Pilote L., Moss A. R. HIV and tuberculosis infection in San Francisco's homeless adults. Prevalence and risk factors in a representative sample. JAMA. 1994 Aug 10;272(6):455–461. [PubMed] [Google Scholar]

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