Neighborhood community characteristics associated with HIV disease outcomes in a cohort of urban women living with HIV

Jane K. Burke-Miller; Kathleen Weber; Susan E. Cohn; Ronald C. Hershow; Beverly E. Sha; Audrey L. French; Mardge H. Cohen

doi:10.1080/09540121.2016.1173642

Neighborhood community characteristics associated with HIV disease outcomes in a cohort of urban women living with HIV

Jane K. Burke-Miller^*, Kathleen Weber, Susan E. Cohn, Ronald C. Hershow, Beverly E. Sha, Audrey L. French, Mardge H. Cohen

^*Corresponding author for this work

Medicine, Infectious Diseases Division

Research output: Contribution to journal › Article › peer-review

30 Scopus citations

Abstract

Recent studies have found geographic variations in immune and viral human immunodeficiency virus (HIV) disease outcomes associated with census measures of neighborhood poverty and segregation. Although readily available, such aggregate census measures are not based on health behavior models and provide limited information regarding neighborhood effect pathways. In contrast, survey-based measures can capture specific aspects of neighborhood disadvantage that may better inform community-based interventions. Therefore, the aim of this study is to assess the measurement validity of multi-dimensional survey measures of neighborhood disorder compared with census measures as predictors of HIV outcomes in a cohort of 197 low-income women in a major metropolitan area. The multi-dimensional survey measures were related to each other and to census measures of concentrated poverty and racial segregation, but not so highly correlated as to be uniform. We found notable variation between community areas in women’s CD4 levels but there was no corresponding geographic variance in viral load, and relationships between community area measures and viral load disappeared after adjustment for individual characteristics, including HIV treatment adherence. In multilevel models adjusting for individual characteristics including substance use, depression, and HIV treatment adherence, one survey measure of neighborhood disadvantage (poor-quality built environment) and one census measure (racial segregation) were significantly associated with greater likelihood of CD4 < 500 (p <.05).

Original language	English (US)
Pages (from-to)	1274-1279
Number of pages	6
Journal	AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume	28
Issue number	10
DOIs	https://doi.org/10.1080/09540121.2016.1173642
State	Published - Oct 2 2016

Funding

The Chicago WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH). WIHS (Principal Investigators): Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590.

Keywords

HIV/AIDS
immune function
neighborhoods
urban health
women

ASJC Scopus subject areas

Health(social science)
Public Health, Environmental and Occupational Health
Social Psychology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1080/09540121.2016.1173642

Cite this

@article{eb6412541dc94b51b7d645a8e009f793,

title = "Neighborhood community characteristics associated with HIV disease outcomes in a cohort of urban women living with HIV",

abstract = "Recent studies have found geographic variations in immune and viral human immunodeficiency virus (HIV) disease outcomes associated with census measures of neighborhood poverty and segregation. Although readily available, such aggregate census measures are not based on health behavior models and provide limited information regarding neighborhood effect pathways. In contrast, survey-based measures can capture specific aspects of neighborhood disadvantage that may better inform community-based interventions. Therefore, the aim of this study is to assess the measurement validity of multi-dimensional survey measures of neighborhood disorder compared with census measures as predictors of HIV outcomes in a cohort of 197 low-income women in a major metropolitan area. The multi-dimensional survey measures were related to each other and to census measures of concentrated poverty and racial segregation, but not so highly correlated as to be uniform. We found notable variation between community areas in women{\textquoteright}s CD4 levels but there was no corresponding geographic variance in viral load, and relationships between community area measures and viral load disappeared after adjustment for individual characteristics, including HIV treatment adherence. In multilevel models adjusting for individual characteristics including substance use, depression, and HIV treatment adherence, one survey measure of neighborhood disadvantage (poor-quality built environment) and one census measure (racial segregation) were significantly associated with greater likelihood of CD4 < 500 (p <.05).",

keywords = "HIV/AIDS, immune function, neighborhoods, urban health, women",

author = "Burke-Miller, {Jane K.} and Kathleen Weber and Cohn, {Susan E.} and Hershow, {Ronald C.} and Sha, {Beverly E.} and French, {Audrey L.} and Cohen, {Mardge H.}",

note = "Funding Information: The Chicago WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH). WIHS (Principal Investigators): Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590. Publisher Copyright: {\textcopyright} 2016 Informa UK Limited, trading as Taylor & Francis Group.",

year = "2016",

month = oct,

day = "2",

doi = "10.1080/09540121.2016.1173642",

language = "English (US)",

volume = "28",

pages = "1274--1279",

journal = "AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV",

issn = "0954-0121",

publisher = "Routledge",

number = "10",

}

TY - JOUR

T1 - Neighborhood community characteristics associated with HIV disease outcomes in a cohort of urban women living with HIV

AU - Burke-Miller, Jane K.

AU - Weber, Kathleen

AU - Cohn, Susan E.

AU - Hershow, Ronald C.

AU - Sha, Beverly E.

AU - French, Audrey L.

AU - Cohen, Mardge H.

N1 - Funding Information: The Chicago WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH). WIHS (Principal Investigators): Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590. Publisher Copyright: © 2016 Informa UK Limited, trading as Taylor & Francis Group.

PY - 2016/10/2

Y1 - 2016/10/2

N2 - Recent studies have found geographic variations in immune and viral human immunodeficiency virus (HIV) disease outcomes associated with census measures of neighborhood poverty and segregation. Although readily available, such aggregate census measures are not based on health behavior models and provide limited information regarding neighborhood effect pathways. In contrast, survey-based measures can capture specific aspects of neighborhood disadvantage that may better inform community-based interventions. Therefore, the aim of this study is to assess the measurement validity of multi-dimensional survey measures of neighborhood disorder compared with census measures as predictors of HIV outcomes in a cohort of 197 low-income women in a major metropolitan area. The multi-dimensional survey measures were related to each other and to census measures of concentrated poverty and racial segregation, but not so highly correlated as to be uniform. We found notable variation between community areas in women’s CD4 levels but there was no corresponding geographic variance in viral load, and relationships between community area measures and viral load disappeared after adjustment for individual characteristics, including HIV treatment adherence. In multilevel models adjusting for individual characteristics including substance use, depression, and HIV treatment adherence, one survey measure of neighborhood disadvantage (poor-quality built environment) and one census measure (racial segregation) were significantly associated with greater likelihood of CD4 < 500 (p <.05).

AB - Recent studies have found geographic variations in immune and viral human immunodeficiency virus (HIV) disease outcomes associated with census measures of neighborhood poverty and segregation. Although readily available, such aggregate census measures are not based on health behavior models and provide limited information regarding neighborhood effect pathways. In contrast, survey-based measures can capture specific aspects of neighborhood disadvantage that may better inform community-based interventions. Therefore, the aim of this study is to assess the measurement validity of multi-dimensional survey measures of neighborhood disorder compared with census measures as predictors of HIV outcomes in a cohort of 197 low-income women in a major metropolitan area. The multi-dimensional survey measures were related to each other and to census measures of concentrated poverty and racial segregation, but not so highly correlated as to be uniform. We found notable variation between community areas in women’s CD4 levels but there was no corresponding geographic variance in viral load, and relationships between community area measures and viral load disappeared after adjustment for individual characteristics, including HIV treatment adherence. In multilevel models adjusting for individual characteristics including substance use, depression, and HIV treatment adherence, one survey measure of neighborhood disadvantage (poor-quality built environment) and one census measure (racial segregation) were significantly associated with greater likelihood of CD4 < 500 (p <.05).

KW - HIV/AIDS

KW - immune function

KW - neighborhoods

KW - urban health

KW - women

UR - http://www.scopus.com/inward/record.url?scp=84964458848&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84964458848&partnerID=8YFLogxK

U2 - 10.1080/09540121.2016.1173642

DO - 10.1080/09540121.2016.1173642

M3 - Article

C2 - 27098593

AN - SCOPUS:84964458848

SN - 0954-0121

VL - 28

SP - 1274

EP - 1279

JO - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV

JF - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV

IS - 10

ER -

Neighborhood community characteristics associated with HIV disease outcomes in a cohort of urban women living with HIV

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this