Changing Places and Partners: Associations of Neighborhood Conditions With Sexual Network Turnover Among African American Adults Relocated From Public Housing
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Neighborhood conditions and sexual network turnover have been associated with the acquisition of HIV and other sexually transmitted infections (STIs). However, few studies investigate the influence of neighborhood conditions on sexual network turnover. This longitudinal study used data collected across 7 visits from a predominantly substance-misusing cohort of 172 African American adults relocated from public housing in Atlanta, Georgia, to determine whether post-relocation changes in exposure to neighborhood conditions influence sexual network stability, the number of new partners joining sexual networks, and the number of partners leaving sexual networks over time. At each visit, participant and sexual network characteristics were captured via survey, and administrative data were analyzed to describe the census tracts where participants lived. Multilevel models were used to longitudinally assess the relationships of tract-level characteristics to sexual network dynamics over time. On average, participants relocated to neighborhoods that were less economically deprived and violent, and had lower alcohol outlet densities. Post-relocation reductions in exposure to alcohol outlet density were associated with fewer new partners joining sexual networks. Reduced perceived community violence was associated with more sexual partners leaving sexual networks. These associations were marginally significant. No post-relocation changes in place characteristics were significantly associated with overall sexual network stability. Neighborhood social context may influence sexual network turnover. To increase understanding of the social–ecological determinants of HIV/STIs, a new line of research should investigate the combined influence of neighborhood conditions and sexual network dynamics on HIV/STI transmission over time.
KeywordsSexual networks HIV/STIs Neighborhoods Longitudinal analysis
This study was funded by two grants from the National Institute on Drug Abuse at the National Institutes of Health (R21DA027072 & R01DA029513), and a grant from the Emory University Center for AIDS research (P30 AI050409). RR was supported by The Georgia State Center of Excellence on Health Disparities (P20MD004806). DFH was partly funded by the Robert W. Woodruff pre-doctoral fellowship of the Emory University Laney Graduate School and a grant from the National Institute of Mental Health at the National Institutes of Health (F31MH105238). Support for EFD was provided by 2T32-MH078788. The authors thank the study participants for sharing their time and insight.
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