Neighborhood community characteristics associated with HIV disease outcomes in a cohort of urban women living with HIV

Dados Bibliográficos

ID19443545
AutoresJane K Burke-Miller (0000-0002-5480-9433, Hektoen Institute, autor correspondente), Kathleen M Weber (Hektoen Institute), Kathleen Weber, Susan E Cohn (0000-0001-5812-2607, Northwestern University), Ronald C Hershow (0000-0003-2996-798X, University of Illinois Chicago), Beverly E Sha (0000-0002-9659-3554, Rush University Medical Center), Audrey L French (0000-0002-9776-8934, Rush University Medical Center), Marsha H Cohen (0000-0002-1351-9624, Cook County Health and Hospitals System), Mardge H Cohen
Ano2016
Volume28
Fascículo10
Páginas1274-1279
Data de publicação2016-10-02
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoAIDS Care (JOURNAL)
Identificadores do periódicoISSN: 0954-0121 • E-ISSN: 1360-0451
EditoraInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2016.1173642
PMID27098593
OpenAlexW2336011586
IdiomaEN
Citações recebidas14
Referências citadas32

Recent studies have found geographic variations in immune and viral human immunodeficiency virus (HIV) disease outcomes associated with census measures of neighborhood poverty and segregation. Although readily available, such aggregate census measures are not based on health behavior models and provide limited information regarding neighborhood effect pathways. In contrast, survey-based measures can capture specific aspects of neighborhood disadvantage that may better inform community-based interventions. Therefore, the aim of this study is to assess the measurement validity of multi-dimensional survey measures of neighborhood disorder compared with census measures as predictors of HIV outcomes in a cohort of 197 low-income women in a major metropolitan area. The multi-dimensional survey measures were related to each other and to census measures of concentrated poverty and racial segregation, but not so highly correlated as to be uniform. We found notable variation between community areas in women's CD4 levels but there was no corresponding geographic variance in viral load, and relationships between community area measures and viral load disappeared after adjustment for individual characteristics, including HIV treatment adherence. In multilevel models adjusting for individual characteristics including substance use, depression, and HIV treatment adherence, one survey measure of neighborhood disadvantage (poor-quality built environment) and one census measure (racial segregation) were significantly associated with greater likelihood of CD4 < 500 (p < .05)

American Community Survey · Census · Cohort · Disadvantage · Environmental health · Geography · Metropolitan area · Political science · Population · Poverty · Psychological intervention · Sociology · Demography · Health disparities and outcomes · HIV, Drug Use, Sexual Risk · Homelessness and Social Issues · Medicine · Gerontology