Longitudinal Associations Between Neighborhood Factors and HIV Care Outcomes in the WIHS
Identifying structural determinants affecting HIV outcomes is important for informing interventions across heterogeneous geographies. Longitudinal hierarchical generalized mixed-effects models were used to quantify the associations between changes in certain structural-level factors on HIV care enga...
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| Published in | AIDS and behavior Vol. 24; no. 10; pp. 2811 - 2818 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
New York
Springer US
01.10.2020
Springer Nature B.V |
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| Online Access | Get full text |
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| Abstract | Identifying structural determinants affecting HIV outcomes is important for informing interventions across heterogeneous geographies. Longitudinal hierarchical generalized mixed-effects models were used to quantify the associations between changes in certain structural-level factors on HIV care engagement, medication adherence, and viral suppression. Among women living with HIV in the WIHS, ten-unit increases in census-tract level proportions of unemployment, poverty, and lack of car ownership were inversely associated with viral suppression and medication adherence, while educational attainment and owner-occupied housing were positively associated with both outcomes. Notably, increased residential stability (aOR 5.68, 95% CI 2.93, 9.04) was positively associated with HIV care engagement, as were unemployment (aOR: 1.59, 95% CI 1.57, 1.60), lack of car ownership (aOR 1.14, 95% CI 1.13, 1.15), and female-headed households (aOR 1.23, 95% CI 1.22, 1.23). This underscores the importance of understanding neighborhood context, including factors that may not always be considered influential, in achieving optimal HIV-related outcomes. |
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| AbstractList | Identifying structural determinants affecting HIV outcomes is important for informing interventions across heterogeneous geographies. Longitudinal hierarchical generalized mixed-effects models were used to quantify the associations between changes in certain structural-level factors on HIV care engagement, medication adherence, and viral suppression. Among women living with HIV in the WIHS, ten-unit increases in census-tract level proportions of unemployment, poverty, and lack of car ownership were inversely associated with viral suppression and medication adherence, while educational attainment and owner-occupied housing were positively associated with both outcomes. Notably, increased residential stability (aOR 5.68, 95% CI 2.93, 9.04) was positively associated with HIV care engagement, as were unemployment (aOR: 1.59, 95% CI 1.57, 1.60), lack of car ownership (aOR 1.14, 95% CI 1.13, 1.15), and female-headed households (aOR 1.23, 95% CI 1.22, 1.23). This underscores the importance of understanding neighborhood context, including factors that may not always be considered influential, in achieving optimal HIV-related outcomes. Identifying structural determinants affecting HIV outcomes is important for informing interventions across heterogeneous geographies. Longitudinal hierarchical generalized mixed-effects models were used to quantify the associations between changes in certain structural-level factors on HIV care engagement, medication adherence, and viral suppression. Among women living with HIV in the WIHS, ten-unit increases in census-tract level proportions of unemployment, poverty, and lack of car ownership were inversely associated with viral suppression and medication adherence, while educational attainment and owner-occupied housing were positively associated with both outcomes. Notably, increased residential stability (aOR 5.68, 95% CI 2.93, 9.04) was positively associated with HIV care engagement, as were unemployment (aOR: 1.59, 95% CI 1.57, 1.60), lack of car ownership (aOR 1.14, 95% CI 1.13, 1.15), and female-headed households (aOR 1.23, 95% CI 1.22, 1.23). This underscores the importance of understanding neighborhood context, including factors that may not always be considered influential, in achieving optimal HIV-related outcomes.Identifying structural determinants affecting HIV outcomes is important for informing interventions across heterogeneous geographies. Longitudinal hierarchical generalized mixed-effects models were used to quantify the associations between changes in certain structural-level factors on HIV care engagement, medication adherence, and viral suppression. Among women living with HIV in the WIHS, ten-unit increases in census-tract level proportions of unemployment, poverty, and lack of car ownership were inversely associated with viral suppression and medication adherence, while educational attainment and owner-occupied housing were positively associated with both outcomes. Notably, increased residential stability (aOR 5.68, 95% CI 2.93, 9.04) was positively associated with HIV care engagement, as were unemployment (aOR: 1.59, 95% CI 1.57, 1.60), lack of car ownership (aOR 1.14, 95% CI 1.13, 1.15), and female-headed households (aOR 1.23, 95% CI 1.22, 1.23). This underscores the importance of understanding neighborhood context, including factors that may not always be considered influential, in achieving optimal HIV-related outcomes. |
| Author | Edmonds, Andrew Benning, Lorie Wentz, Eryka Adimora, Adaora Adedimeji, Adebola Wilson, Tracey E. Palar, Kartika Chandran, Aruna Cohen, Mardge Blair-Spence, Amanda |
| AuthorAffiliation | 2 Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 3 Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA 4 Department of Community Health Sciences, State University of New York, Downstate Health Sciences University, School of Public Health, Brooklyn, NY, USA 5 Department of Medicine, Division of Infectious Disease and Travel Medicine, Georgetown University, Washington, DC, USA 6 Division of HIV, Infectious Disease and Global Medicine, School of Medicine, University of California, San Francisco, CA, USA 1 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA 7 Cook County Health and Hospital System, Chicago, IL, USA |
| AuthorAffiliation_xml | – name: 6 Division of HIV, Infectious Disease and Global Medicine, School of Medicine, University of California, San Francisco, CA, USA – name: 1 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA – name: 4 Department of Community Health Sciences, State University of New York, Downstate Health Sciences University, School of Public Health, Brooklyn, NY, USA – name: 3 Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA – name: 5 Department of Medicine, Division of Infectious Disease and Travel Medicine, Georgetown University, Washington, DC, USA – name: 2 Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA – name: 7 Cook County Health and Hospital System, Chicago, IL, USA |
| Author_xml | – sequence: 1 givenname: Aruna surname: Chandran fullname: Chandran, Aruna email: achandr3@jhu.edu organization: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health – sequence: 2 givenname: Andrew surname: Edmonds fullname: Edmonds, Andrew organization: Department of Epidemiology, The University of North Carolina at Chapel Hill – sequence: 3 givenname: Lorie surname: Benning fullname: Benning, Lorie organization: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health – sequence: 4 givenname: Eryka surname: Wentz fullname: Wentz, Eryka organization: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health – sequence: 5 givenname: Adebola surname: Adedimeji fullname: Adedimeji, Adebola organization: Department of Epidemiology & Population Health, Albert Einstein College of Medicine – sequence: 6 givenname: Tracey E. surname: Wilson fullname: Wilson, Tracey E. organization: Department of Community Health Sciences, School of Public Health, State University of New York, Downstate Health Sciences University – sequence: 7 givenname: Amanda surname: Blair-Spence fullname: Blair-Spence, Amanda organization: Division of Infectious Disease and Travel Medicine, Department of Medicine, Georgetown University – sequence: 8 givenname: Kartika surname: Palar fullname: Palar, Kartika organization: Division of HIV, Infectious Disease and Global Medicine, School of Medicine, University of California – sequence: 9 givenname: Mardge surname: Cohen fullname: Cohen, Mardge organization: Cook County Health and Hospital System – sequence: 10 givenname: Adaora surname: Adimora fullname: Adimora, Adaora organization: Department of Epidemiology, The University of North Carolina at Chapel Hill |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32170507$$D View this record in MEDLINE/PubMed |
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| Copyright | Springer Science+Business Media, LLC, part of Springer Nature 2020 Springer Science+Business Media, LLC, part of Springer Nature 2020. |
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| Title | Longitudinal Associations Between Neighborhood Factors and HIV Care Outcomes in the WIHS |
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