Neighborhood Context and Black Heterosexual Men’s Sexual HIV Risk Behaviors

• Published in: AIDS and behavior Vol. 18; no. 11; pp. 2207 - 2218
• Main Authors: Bowleg, Lisa, Neilands, Torsten B., Tabb, Loni Philip, Burkholder, Gary J., Malebranche, David J., Tschann, Jeanne M.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.11.2014; Springer Nature B.V
• Subjects: Acquired Immune Deficiency Syndrome; Adolescent; Adult; African Americans - psychology; African Americans - statistics & numerical data; Black people; Cross-Sectional Studies; Depression (Psychology); Depression - epidemiology; Drug Abuse; Health Psychology; Health risks; Heterosexuality; Heterosexuality - psychology; Heterosexuality - statistics & numerical data; HIV; HIV Infections - psychology; HIV Infections - transmission; Human immunodeficiency virus; Humans; Infectious Diseases; Male; Males; Medicine; Medicine & Public Health; Men; Middle Aged; Neighborhoods; Original Paper; Philadelphia - epidemiology; Public Health; Residence Characteristics - statistics & numerical data; Risk; Risk Factors; Risk taking; Sexual behavior; Sexually transmitted diseases; Socioeconomic Factors; STD; Substance Abuse; Substance use; Substance-Related Disorders - epidemiology; Threat; Unsafe Sex - psychology; Unsafe Sex - statistics & numerical data; Young Adult; Philadelphia; USA, Pennsylvania, Philadelphia; Substance use; Neighborhood context; Contexto del vecindario; Violencia urbana; Hombres negros heterosexuales; Depresión; Depression; Riesgo de VIH; Black heterosexual men; HIV risk; Uso de sustancias; Urban violence
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-014-0803-2

The effects of neighborhood context on sexual risk behavior are understudied, particularly 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 low-income urban U.S. communities underscores the importance of examining the effects of neighborhood context on Black heterosexual men’s sexual risk, however. We used structural equation modeling to test the pathways between neighborhood context (neighborhood disorder, personal violence, neighborhood threats), depression, substance use, and sexual risk behavior. Participants were 526 self-identified Black heterosexual men, ages 18–45, recruited via randomized venue-based probability sampling in Philadelphia, PA. Analyses of model fit statistics from Mplus indicated statistically significant direct pathways between neighborhood context, depression, substance use, and sexual risk behavior. The total indirect effect of neighborhood context on sexual risk behavior through substance use was also significant. The study’s results highlight a need for more research on neighborhood context and sexual HIV risk, and for multilevel interventions to address the effects of negative neighborhood context on Black heterosexual men’s sexual HIV risk.