142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Healthography and Black Heterosexual Men's Sexual HIV Risk: The Role of Neighborhood Context

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 4:45 PM - 5:00 PM

Lisa Bowleg, PhD , Department of Psychology, The George Washington University, Washington, DC
Torsten B. Neilands, PhD , Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA
Loni Philip Tabb, PhD , School of Public Health, Drexel University, Philadelphia, PA
Gary J. Burkholder, PhD , Department of Business Operations, The National Hispanic University, San Jose, CA
Jeanne Tschann, PhD , Department of Psychiatry, University of California, San Francisco, San Francisco, CA
Background: Individuals, rather than social-structural factors, have been the primary focus of most HIV prevention research.  Consequently, considerable gaps exist about how social-structural factors such as neighborhoods facilitate or hinder sexual HIV risk.  This is particularly the case for Black heterosexual men who do not inject drugs or report heavy drug use.  Evidence of a generalized HIV epidemic (>1%) among Black heterosexuals in impoverished urban U.S. communities, underscore the need for more research on neighborhood context and sexual HIV risk for Black heterosexual men.

Method: We used structural equation modeling (Mplus 7.11) to test a model of the pathways between neighborhood context (neighborhood disorder, personal and neighborhood violence), depression, substance use, and Black sexual risk behavior. Participants were 526 self-identified Black heterosexual men, ages 18 to 45 recruited in Philadelphia, PA via randomized venue-based probability sampling (e.g., restaurants, corner stores).

Results: With the exception of the hypothesized pathway between depression and substance use, all hypothesized direct pathways were significant. We observed significant positive direct effects from neighborhood context, depression, and substance use on sexual risk.  Results suggest that variability in sexual risk is explained by direct influences of neighborhood context, depression, and substance use, with the latter also being a conduit through which additional neighborhood context effects exert influence.

Conclusion: In the context of Black heterosexual men’s sexual HIV risk, healthography matters.  Our study underscores the need for more research and interventions to address and reduce the effects of negative neighborhood context on Black heterosexual men’s sexual HIV risk behaviors.

Learning Areas:

Diversity and culture
Social and behavioral sciences

Learning Objectives:
Describe structural equation modeling approach to examining neighborhood context on Black heterosexual menís sexual HIV risk Demonstrate the importance of neighborhood context for understanding sexual HIV risk Discuss the need for social-structurally informed HIV interventions that incorporate neighborhood context

Keyword(s): HIV Risk Behavior, Urban Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI of the NIH/NICH grant that funded this study.
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.