Associations Between Neighborhood Characteristics, Social Cohesion, and Perceived Sex Partner Risk and Non-Monogamy Among HIV-Seropositive and HIV-Seronegative Women in the Southern U.S.
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Neighborhood social and physical factors shape sexual network characteristics in HIV-seronegative adults in the U.S. This multilevel analysis evaluated whether these relationships also exist in a predominantly HIV-seropositive cohort of women. This cross-sectional multilevel analysis included data from 734 women enrolled in the Women’s Interagency HIV Study’s sites in the U.S. South. Census tract-level contextual data captured socioeconomic disadvantage (e.g., tract poverty), number of alcohol outlets, and number of non-profits in the census tracts where women lived; participant-level data, including perceived neighborhood cohesion, were gathered via survey. We used hierarchical generalized linear models to evaluate relationships between tract characteristics and two outcomes: perceived main sex partner risk level (e.g., partner substance use) and perceived main sex partner non-monogamy. We tested whether these relationships varied by women’s HIV status. Greater tract-level socioeconomic disadvantage was associated with greater sex partner risk (OR 1.29, 95% CI 1.06–1.58) among HIV-seropositive women and less partner non-monogamy among HIV-seronegative women (OR 0.69, 95% CI 0.51–0.92). Perceived neighborhood trust and cohesion was associated with lower partner risk (OR 0.83, 95% CI 0.69–1.00) for HIV-seropositive and HIV-seronegative women. The tract-level number of alcohol outlets and non-profits were not associated with partner risk characteristics. Neighborhood characteristics are associated with perceived sex partner risk and non-monogamy among women in the South; these relationships vary by HIV status. Future studies should examine causal relationships and explore the pathways through which neighborhoods influence partner selection and risk characteristics.
KeywordsHIV Neighborhood characteristics Sexual risk Multilevel analyses Social cohesion
The authors thank the Women’s Interagency HIV Study participants for sharing their time and experiences. The authors also acknowledge the efforts and dedication of WIHS study staff, with special thanks to Ighovwerha Ofotokun, Sarah Sanford, Deja Er, Rachael Farah-Abraham, Carrigan Parrish, Zenoria Causey, Venetra McKinney, Erin Balvanz, and Lisa Rohn. In addition, the authors express sincere thanks to the regulatory and law enforcement agencies that provided data needed to construct census tract predictors.
This work was supported by the National Institute of Mental Health of the National Institutes of Health under Award Number F31MH105238, the Surgeon General C. Everett Koop HIV/AIDS Research Grant, the George W. Woodruff Fellowship of the Laney Graduate School, the Emory Center for AIDS Research (P30 AI050409), the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number K01HD074726, and the Centers for Disease Control and Prevention under Cooperative Agreement U01PS003315 as part of the Minority HIV/AIDS Research Initiative. Participant data in this manuscript were collected by the Women’s Interagency HIV Study (WIHS): UAB-MS WIHS (PIs: Michael Saag, Mirjam-Colette Kempf, and Deborah Konkle-Parker), U01-AI-103401; Atlanta WIHS (PIs: Ighovwerha Ofotokun and Gina Wingood), U01-AI-103408; Miami WIHS (PIs: Margaret Fischl and Lisa Metsch), U01-AI-103397; UNC WIHS (PI: Adaora Adimora) U01-AI-103390; WIHS Data Management and Analysis Center (PIs: Stephen Gange and Elizabeth Golub) U01-AI-042590. The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases, with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute on Mental Health. Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research, the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Deafness and other Communication Disorders, and the NIH Office of Research on Women’s Health. WIHS data collection is also supported by UL1-TR000454 (Atlanta CTSA). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health. The NC Department of Health and Human Services does not take responsibility for the scientific validity or accuracy of methodology, results, statistical analyses, or conclusions presented.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Human and Animal Rights
This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study. This secondary analysis is restricted to individual participants who provided written informed consent to collect and geocode their home address.
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