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 - Funding Information:
Data in this manuscript were collected by the Women’s Interagency HIV Study (U01-HL146193), now the MACS/WIHS Combined Cohort Study (MWCCS). We acknowledge the time and effort of all participating women and their families. 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 (NIH). MWCCS (Principal Investigators): Bronx CRS (Kathryn Anastos and Anjali Sharma), U01‐HL146204; Brooklyn CRS (Deborah Gustafson and Tracey Wilson), U01‐HL146202; Data Analysis and Coordination Center (Gypsyamber D’Souza, Stephen Gange and Elizabeth Golub), U01‐HL146193; Chicago‐Cook County CRS (Mardge Cohen and Audrey French), U01‐HL146245; Connie Wofsy Women’s HIV Study, Northern California CRS (Bradley Aouizerat and Phyllis Tien), U01‐HL146242; Metropolitan Washington CRS (Seble Kassaye and Daniel Merenstein), U01‐HL146205; UNC CRS (Adaora Adimora), U01‐HL146194; Atlanta CRS (Ighovwerha Ofotokun, Anandi Sheth, and Gina Wingood), U01‐HL146241; Miami CRS (Maria Alcaide, Margaret Fischl, and Deborah Jones), U01‐HL146203; UAB‐MS CRS (Mirjam‐Colette Kempf and Deborah Konkle‐Parker), U01‐HL146192; and Southern California WIHS (Joel Milam), U01-HD-032632 (WIHS I – WIHS IV). The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional co‐funding from the Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD), National Human Genome Research Institute (NHGRI), National Institute On Aging (NIA), National Institute Of Dental & Craniofacial Research (NIDCR), National Institute Of Allergy And Infectious Diseases (NIAID), National Institute Of Neurological Disorders And Stroke (NINDS), National Institute Of Mental Health (NIMH), National Institute On Drug Abuse (NIDA), National Institute Of Nursing Research (NINR), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). MWCCS data collection is also supported by UL1TR000004 (UCSF CTSA), P30‐AI‐050409 (Atlanta CFAR), P30‐AI‐050410 (UNC CFAR), and P30‐AI‐027767 (UAB CFAR).
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 -