Neighborhood Stress and its Relationship to Risk Behaviors; Preliminary Analysis of Project iMPPACS

Purpose: Determine associations between self-reported risk behaviors and neighborhood stress among a sample of African-American adolescents as a component of the NIH-funded Project iMPPACS, a multi-level, multi-site HIV/STI prevention intervention.

Subjects: Data were collected on 452 African American adolescents (age 14-17) residing in Columbia, SC.

Design: A cross-sectional design was utilized with measurement data collected over one year.

Methods: Audio Computer Assisted Self Interview (ACASI)Surveys assessed measurements for neighborhood stress, substance use (alcohol, tobacco, marijuana), drug distribution, violent/aggressive behavior, penal discipline, and sexual behavior. All participants submitted a biospecimen for testing and subsequent treatment if positive for Chlamydia, Gonorrhea, and/or Trichomoniasis.

Analysis: Logistic regression was performed to determine the likelihood of association between a quasi-continuous neighborhood stress variable and dichotomous outcome variables.

Results: Living in lower stress neighborhoods was found to be protective against engaging in vaginal intercourse (OR=.59, C.I.=0.38-0.92), smoking (OR=2.69, C.I.=0.35-0.85), recent alcohol use (OR=0.54, C.I.=0.03-0.62), and marijuana use (OR=0.46, C.I.=0.29-0.76) but significantly associated with drug distribution (OR=5.23, C.I.=1.86-14.75) and fighting (OR=2.69, C.I.=1.71-4.23). Living in higher stress neighborhoods was protective against drug distribution (OR=0.25, C.I.=0.14-0.46) and fighting (OR=0.42, C.I.=0.22-0.78) but significantly associated with engaging in oral sex (OR=2.01, C.I.=1.10-3.79), penal discipline (OR=3.41, C.I.=1.93-6.01), smoking (OR=7.00, C.I.=3.12-15.69) and marijuana use (OR=3.86, C.I.=2.21-6.72).

Conclusion: Neighborhood stress is a useful indicator for predicting various risk behaviors of adolescents. Interventions and policies should focus on addressing structural determinants of health among populations that exhibit health disparities.