Longitudinal Associations Between Neighborhood Factors and HIV Care Outcomes in the WIHS

Aruna Chandran, Andrew Edmonds, Lorie Benning, Eryka Wentz, Adebola Adedimeji, Tracey E. Wilson, Amanda Blair-Spence, Kartika Palar, Mardge Cohen, Adaora Adimora

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)2811-2818
Number of pages8
JournalAIDS and behavior
Issue number10
StatePublished - Oct 1 2020


  • Adherence
  • Care engagement
  • HIV
  • Neighborhood determinants
  • WIHS

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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