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Neighborhood community characteristics associated with HIV disease outcomes in a cohort of urban women living with HIV.
- Source :
- AIDS Care; Oct2016, Vol. 28 Issue 10, p1274-1279, 6p, 3 Charts
- Publication Year :
- 2016
-
Abstract
- 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). [ABSTRACT FROM AUTHOR]
- Subjects :
- HIV-positive persons
HIV infections
EVALUATION of medical care
RELIABILITY (Personality trait)
SUBSTANCE abuse
CONFIDENCE intervals
RESEARCH methodology evaluation
VIRAL load
RACE
INCOME
QUESTIONNAIRES
CD4 lymphocyte count
DRUGS
MENTAL depression
DESCRIPTIVE statistics
INTRACLASS correlation
RESEARCH funding
METROPOLITAN areas
POVERTY
PATIENT compliance
ODDS ratio
WOMEN'S health
PROBABILITY theory
Subjects
Details
- Language :
- English
- ISSN :
- 09540121
- Volume :
- 28
- Issue :
- 10
- Database :
- Complementary Index
- Journal :
- AIDS Care
- Publication Type :
- Academic Journal
- Accession number :
- 117828864
- Full Text :
- https://doi.org/10.1080/09540121.2016.1173642