Online Program

How does neighborhood impact engagement in HIV-related risk behaviors?

Monday, November 4, 2013 : 2:30 p.m. - 2:45 p.m.

Enbal Shacham, PhD, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO
Min Lian, MD, PhD, Department of Medicine, Washington University School of Medicine, St. Louis, MO
Rachel Presti, MD, PhD, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO
E. Turner Overton, MD, Division of Infectious Diseases, University of Alabama Birmingham, Birmingham, AL
J. Aaron Hipp, PhD, Brown School, Washington University, St. Louis, MO
Mark Bloomfield, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO
Ryan Murphy, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO
HIV infection has become a manageable chronic disease due to treatment advances. Secondary prevention efforts have proven inadequate to reduce the estimated incidence of new HIV infections. Epidemiologic data suggests that geographic clustering of new HIV infections is a common phenomenon, particularly in urban areas among populations of low socioeconomic status. This study aims to assess the relationship between neighborhood conditions and HIV management and engagement in high-risk behaviors. During routine outpatient HIV clinic visits, 762 individuals from the St. Louis metropolitan area completed behavioral and psychological assessments. Biomedical markers were abstracted from their medical records. Census level factors were used with ArcGIS to analyze relationships between health behaviors and outcomes by neighborhood variables. The majority of the sample was male and African American. In the adjusted models, individuals residing in neighborhoods with higher poverty rate were more likely to have lower CD4 cell counts and more likely to be current smoker. In neighborhoods with higher rates of unemployment, individuals were less likely to have a current antiretroviral prescription. In more racially segregated neighborhoods, individuals reported more depressive symptoms. Additional analyses will include the relationship of neighborhood resources (alcohol- and condom-selling establishments, clinic distances) understanding that impact health outcomes Despite the advances in HIV disease management, disparities among HIV care continue to adversely affect efforts to prevent disease progression and transmission. Interventions that address neighborhood conditions as barriers to HIV management may provide improved health outcomes.

Learning Areas:

Chronic disease management and prevention
Program planning
Social and behavioral sciences

Learning Objectives:
Identify neighborhood characteristics that influence engagement in HIV-related risk behaviors Define neighborhood factors that may be protective to improving health outcomes

Keyword(s): HIV Risk Behavior, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI on the federally funded grant that conducted this analysis to assess relationship between neighborhood and HIV-related health outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.