Background This study examined temporal and spatial relationships between neighbourhood drug markets and gonorrhoea among census block groups from 2002 to 2005. Our central hypotheses was that drug markets through their drug and sex economies set up dense sexual networks among a high STI prevalence group which creates conditions that are necessary and sufficient for STI transmission.
Methods The study design was a spatial, longitudinal ecologic study. The primary outcome of interest was age and sex standardised gonorrhoea counts from 2002 to 2005. The primary exposure of interest was drug markets defined as illicit drug dealing within a specific geographic area and measured using drug market arrest data. Poisson regression was utilised with adjustment in final models for socioeconomic status, stability and vacant housing.
Results Increased drug market arrests in a focal neighbourhood were significantly associated with a 15% increase gonorrhoea (Adjusted RR 1.15; 95% CI 1.09, 1.20). Increased drug market arrests in adjacent neighbourhoods were significantly associated with a 32% increase in gonorrhoea (ARR 1.32; 95% CI 1.22, 1.42), independent of focal neighbourhood drug markets. Increased drug market arrests in the previous year in the focal neighbourhood were not associated with increases in gonorrhoea (ARR 1.00; 95% CI 0.95, 1.06), adjusting for focal and adjacent neighbourhood drug markets.
Conclusion While the temportal lag of one year was not supported, our findings support an associative link between drug markets and gonorrhoea. The findings suggest that drug markets and their associated sexual networks may extend beyond local neighbourhood boundaries indicating the importance of including spatial lag effects in regression models investigating these associations.
- drug markets
- spatial analyses
- transmission dynamics
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