Background: Living in a neighborhood with a low socioeconomic context may increase the risk of coronary heart disease. However, few studies have explored the impact of neighborhood characteristics on subclinical atherosclerosis, and their role as a risk factor for cardiovascular disease has not yet been studied in poor countries. Objectives: This study aimed to investigate the association between perceived neighborhood characteristics and subclinical atherosclerosis in a large sample of adults, using cross-sectional data from the ELSA-Brasil (Brazilian Longitudinal Study of Adult Health). Methods: Participants free of clinical coronary artery disease answered a questionnaire designed to assess their perceptions regarding 6 neighborhood dimensions: social cohesion, walkability, availability of healthy food, safety, witnessed violence, and personal victimization. The scores of each domain were used as independent variables. Common carotid intima-media thickness (CCIMT) was used as a dependent variable. Then linear regression models, adjusted by demographic, socioeconomic, and cardiovascular factors, were used. Results: A total of 9,923 adults (mean age ¼ 51.5 AE 8.9 years, 44% male, 55% white) were examined. In the univariate analysis, better walkability (b ¼ À0.62, 95% confidence interval [CI]: À1.01 to À0.23; p ¼ 0.002) and low witnessed violence (b ¼ À1.95; 95% CI: À2.96 to-0.94; p < 0.0001) were associated with lower CCIMT, whereas low personal victimization was associated with higher CCIMT (b ¼ 10.70; 95% CI: 4.55 to 16.85; p ¼ 0.001). A borderline interaction between neighborhood domain and sex was found. Better social cohesion may be associated with larger CCIMT among women, whereas better safety was associated with lower CCIMT among men. Multiple imputation for missing CCIMT data showed similar results. Conclusions: The perception of living in a more walkable environment and in a neighborhood where people witness fewer violent episodes can provide protection on the early phases of the atherosclerosis process. Less stress and the practice of physical activity may explain the protection.

Despite solid scientific evidence, the concepts of treatment as prevention (TASP) and Undetectable = Untransmittable (U = U) remain unfamiliar and underutilized for some healthcare providers. We conducted a self-completion survey to evaluate the knowledge of TASP/U = U in different medical specialties. Wilcoxon Rank-Sum, Chi-square and Fisher’s exact tests were used for group comparisons and a logistic regression model was used to assess factors independently associated with U = U-non-supportive attitudes. 197 physicians were included; 74% agreed/strongly agreed that people living with HIV (PLHIV) under regular treatment with undetectable viral do not transmit HIV sexually. However, only 66% agree/strongly agree that PLHIV should be informed about that. The knowledge about these concepts was poorer among gynecologists, urologists and internal medicine specialists when compared to infectious diseases specialists after adjustment for age, race/skin color, gender, and sexual orientation. Our study found that knowledge of crucial concepts of HIV prevention may be lacking for some medical specialties. This highlights the need of improvement in medical education.

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