Changing Places and Partners: Associations of Neighborhood Conditions With Sexual Network Turnover Among African American Adults Relocated From Public Housing

Abstract

Neighborhood conditions and sexual network turnover have been associated with the acquisition of HIV and other sexually transmitted infections [HIV/STIs]. However, few studies investigate the influence of neighborhood conditions on sexual network turnover. This longitudinal study uses 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 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.

HIV-Prevalence in South Africa by settlement type: A repeat population-based cross-sectional analysis of men and women

“…Even after adjustment for potential co-founders, informal settlements consistently had higher HIV-prevalence than other settlement types, suggesting there remained unmeasured factors. Housing in informal settlements can be unstable, and studies from North America have highlighted how housing instability is an independent risk factor for HIV and STIs [25]. It may also be that settlement type is a proxy for sexual networks; studies in North America have highlighted how dense sexual networks, shaped by poverty and racism, are crucial for HIV-transmission patterns [26].…”

“…More widely, this analysis suggests that settlement type may be important in understanding the spatial distribution of HIV in South Africa, and elsewhere. Such spatial patterning of HIV reflects patterns of wider marginalization of those who live there, including race, gender and poverty [1,25,26]. Further investigation into how these factors intersect to shape high HIVincidence and prevalence is critical to understand how best to prevent HIV, and ensure HIVtreatment is available to all.…”

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.

“…The number of alcohol outlets in the tract was not associated with partner non-monogamy nor partner risk. Although ecologic studies have found relationships between alcohol outlets and STIs (Cohen et al, 2006; Theall et al, 2009), findings of multilevel studies assessing relationships between alcohol outlets and sexual partnerships in adults have been mixed (Cooper et al, 2015; Linton et al, 2017). It is possible that alcohol outlets indirectly impact women's sexual health by promoting alcohol use and subsequently, higher sexual risk behaviors (Campbell et al, 2009; Cooper et al, 2013; Linton et al, 2017; Linton, Haley, Hunter-Jones, Ross, & Cooper, 2017; Seth, Wingood, & DiClemente, 2008).…”

The Social and Sexual Networks of Black Transgender Women and Black Men Who Have Sex with Men: Results from a Representative Sample

“…Similarly, a stability ratio was calculated for the confidant and sexual networks of ever respondent with two or more study visits. 39,52,53 The stability ratio was calculated as the number of retained ties divided by the original network size.…”