Neighborhood Condition and Geographic Locale in Assessing HIV/STI Risk Among African American Adolescents

Kerr, Jelani; Valois, Robert F.; Siddiqi, Arjumand; Vanable, Peter A.; Carey, Michael P.

doi:10.1007/s10461-014-0868-y

Cited by 24 publications

(24 citation statements)

References 37 publications

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“…First, much of the research in this area has been conducted with adolescents (e.g., Brady, 2006; Brahmbhatt et al, 2014; Kerr, Valois, Siddiqi, Vanable, & Carey, 2015; Voisin, 2005; Wilson et al, 2012); there is limited research on the relation between community violence and sexual risk behavior among adults. Second, although SES, at the individual level and at the community level, is a correlate of both sexual risk behavior (Carlson et al, 2014; Cubbin et al, 2005; Ford & Browning, 2014; Voisin et al, 2014) and community violence (Ewart & Suchday, 2002; Morenoff, Sampson, & Raudenbush, 2001), research on community violence has rarely controlled for SES.…”

Section: Introductionmentioning

confidence: 99%

Mediators of the Relation Between Community Violence and Sexual Risk Behavior Among Adults Attending a Public Sexually Transmitted Infection Clinic

2016

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Prior research shows that violence is associated with sexual risk behavior, but little is known about the relation between community violence (i.e., violence that is witnessed or experienced in one's neighborhood) and sexual risk behavior. To better understand contextual influences on HIV risk behavior, we asked 508 adult patients attending a publicly-funded STI clinic in the U.S. (54% male, Mage = 27.93, 68% African American) who were participating in a larger trial to complete a survey assessing exposure to community violence, sexual risk behavior, and potential mediators of the community violence-sexual risk behavior relation (i.e., mental health, substance use, and experiencing intimate partner violence). A separate sample of participants from the same trial completed measures of sexual behavior norms, which were aggregated to create measures of census tract sexual behavior norms. Data analyses controlling for socioeconomic status revealed that higher levels of community violence were associated with more sexual partners for men and with more episodes of unprotected sex with non-steady partners for women. For both men and women, substance use and mental health mediated the community violence-sexual risk behavior relation; in addition, for men only, experiencing intimate partner violence also mediated this relation. These results confirm that, for individuals living in communities with high levels of violence, sexual risk reduction interventions need to address intimate partner violence, substance use, and mental health to be optimally effective.

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Section: Introductionmentioning

confidence: 99%

Mediators of the Relation Between Community Violence and Sexual Risk Behavior Among Adults Attending a Public Sexually Transmitted Infection Clinic

2016

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“…Researchers have documented individual, social, and structural factors that drive local epidemics (Brawner, Gomes, Jemmott, Deatrick, & Coleman, 2012; Kerr, Valois, Siddiqi, Vanable, & Carey, 2014; Nunn et al, 2011). More specifically, disproportionate HIV/AIDS infection rates among Blacks may be attributable to the hyper-incarceration of Black men, poverty, racism, and a paucity of harm reduction (e.g., syringe exchange) and comprehensive sexual health education programs (Adimora & Auerbach, 2010; Blankenship, West, Kershaw, & Biradavolu, 2008; Bowleg & Raj, 2012).…”

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confidence: 99%

Multilevel Drivers of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Among Black Philadelphians

et al. 2015

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Background Unequal HIV/AIDS distribution is influenced by certain social and structural contexts that facilitate HIV transmission and concentrate HIV in disease epicenters. Thus, one of the first steps in designing effective community-level HIV/AIDS initiatives is to disentangle the influence of individual, social, and structural factors on HIV risk. Combining ethnographic methodology with geographic information systems (GIS) mapping can allow for a complex exploration of multilevel factors within communities that facilitate HIV transmission in highly affected areas. Objectives We present the formative comparative community-based case study findings of an investigation of individual-, social- , and structural-level factors that contribute to the HIV/AIDS epidemic among Black Philadelphians. Methods Communities were defined using census tracts. The methodology included ethnographic and GIS mapping, observation, informal conversations with residents and business owners, and secondary analyses of census tract-level data in four Philadelphia neighborhoods. Results Factors such as overcrowding, disadvantage, permeability in community boundaries, and availability and accessibility of health-related resources varied significantly. Further, HIV/AIDS trended with social and structural inequities above and beyond the community’s racial composition. Discussion This study was a first step to disentangle relationships between community-level factors and potential risk for HIV in an HIV epicenter. The findings also highlight stark sociodemographic differences within and across racial groups, and further substantiate the need for comprehensive, community-level HIV prevention interventions. These findings from targeted United States urban communities have potential applicability for examining the distribution of HIV/AIDS in broader national and international geosocial contexts.

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“…Living in high-stress neighborhood conditions has been associated with increased risk for HIV/sexually transmitted infection transmission [ 35 ], sexual risk behavior, and substance abuse [ 36 ]. Recognizing that these factors have contributed to the high HIV prevalence in the LINK-targeted neighborhoods, the CBI partners sought to develop an intervention that was relatively easy to implement through mobile delivery of their existing services to improve community access to diagnosis and care.…”

Section: Discussionmentioning

confidence: 99%

An Integrated Service Delivery Model to Identify Persons Living with HIV and to Provide Linkage to HIV Treatment and Care in Prioritized Neighborhoods: A Geotargeted, Program Outcome Study

Frew¹,

Archibald²,

Schamel³

et al. 2015

JMIR Public Health Surveill

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BackgroundRecent studies have demonstrated that high human immunodeficiency virus (HIV) prevalence (2.1%) rates exist in “high-risk areas” of US cities that are comparable to rates in developing nations. Community-based interventions (CBIs) have demonstrated potential for improving HIV testing in these areas, thereby facilitating early entry and engagement in the HIV continuum of care. By encouraging neighborhood-based community participation through an organized community coalition, Project LINK sought to demonstrate the potential of the CBI concept to improve widespread HIV testing and referral in an area characterized by high poverty and HIV prevalence with few existing HIV-related services.ObjectiveThis study examines the influence of Project LINK to improve linkage-to-care and HIV engagement among residents of its target neighborhoods.MethodsUsing a venue-based sampling strategy, survey participants were selected from among all adult participants aged 18 years or more at Project LINK community events (n=547). We explored multilevel factors influencing continuum-of-care outcomes (linkage to HIV testing and CBI network referral) through combined geospatial-survey analyses utilizing hierarchical linear model methodologies and random-intercept models that adjusted for baseline effect differences among zip codes. The study specifically examined participant CBI utilization and engagement in relation to individual and psychosocial factors, as well as neighborhood characteristics including the availability of HIV testing services, and the extent of local prevention, education, and clinical support services.ResultsStudy participants indicated strong mean intention to test for HIV using CBI agencies (mean 8.66 on 10-point scale [SD 2.51]) and to facilitate referrals to the program (mean 8.81 on 10-point scale [SD 1.86]). Individual-level effects were consistent across simple multiple regression and random-effects models, as well as multilevel models. Participants with lower income expressed greater intentions to obtain HIV tests through LINK (P<.01 across models). HIV testing and CBI referral intention were associated with neighborhood-level factors, including reduced availability of support services (testing P<.001), greater proportion of black/African Americans (testing and referral P<.001), and reduced socioeconomic capital (testing P=.017 and referral P<.001). Across models, participants expressing positive attitudes toward the CBI exhibited greater likelihood of engaging in routine HIV testing (P<.01) and referring others to HIV care (P<.01). Transgender individuals indicated greater intent to refer others to the CBI (P<.05). These outcomes were broadly influenced by distal community-level factors including availability of neighborhood HIV support organizations, population composition socioeconomic status, and high HIV prevalence.ConclusionsProject LINK demonstrated its potential as a geotargeted CBI by evidencing greater individual intention to engage in HIV testing, care, and personal referrals to its coalition...

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Neighborhood Condition and Geographic Locale in Assessing HIV/STI Risk Among African American Adolescents

Cited by 24 publications

References 37 publications

Mediators of the Relation Between Community Violence and Sexual Risk Behavior Among Adults Attending a Public Sexually Transmitted Infection Clinic

Mediators of the Relation Between Community Violence and Sexual Risk Behavior Among Adults Attending a Public Sexually Transmitted Infection Clinic

Multilevel Drivers of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Among Black Philadelphians

An Integrated Service Delivery Model to Identify Persons Living with HIV and to Provide Linkage to HIV Treatment and Care in Prioritized Neighborhoods: A Geotargeted, Program Outcome Study

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