TY - JOUR
T1 - Longitudinal Associations Between Neighborhood Factors and HIV Care Outcomes in the WIHS
AU - Chandran, Aruna
AU - Edmonds, Andrew
AU - Benning, Lorie
AU - Wentz, Eryka
AU - Adedimeji, Adebola
AU - Wilson, Tracey E.
AU - Blair-Spence, Amanda
AU - Palar, Kartika
AU - Cohen, Mardge
AU - Adimora, Adaora
N1 - Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - 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.
AB - 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.
KW - Adherence
KW - Care engagement
KW - HIV
KW - Neighborhood determinants
KW - WIHS
UR - http://www.scopus.com/inward/record.url?scp=85082042608&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85082042608&partnerID=8YFLogxK
U2 - 10.1007/s10461-020-02830-4
DO - 10.1007/s10461-020-02830-4
M3 - Article
C2 - 32170507
AN - SCOPUS:85082042608
SN - 1090-7165
VL - 24
SP - 2811
EP - 2818
JO - AIDS and behavior
JF - AIDS and behavior
IS - 10
ER -