Neighborhood Factors Associated with Racial/Ethnic Disparities in Achieving Sustained HIV Viral Suppression Among Miami-Dade County Ryan White Program Clients

Dawit, Rahel; Trepka, Mary Jo; Duncan, Dustin T.; Li, Tan; Pires, Stephen F.; Brock, Petra; Ladner, Robert A.; Sheehan, Diana M.

doi:10.1089/apc.2021.0067

Cited by 9 publications

(7 citation statements)

References 41 publications

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“…Systemic racism contributes to racial disparities in HIV outcomes [6][7][8][9]. For example, disadvantage in predominantly Black neighborhoods is largely due to systemic racism embedded in historical and current housing policies (e.g., residential segregation) [10][11][12] and is a robust correlate of HIV [13,14]. African American/Black individuals disproportionately reside in high-risk neighborhood environments characterized by intentional disinvestment, socioeconomic deprivation, and/or social and physical disorder [2,[13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Multilevel Resilience and HIV Virologic Suppression Among African American/Black Adults in the Southeastern United States

Park

Wilson-Barthes

Dulin

et al. 2023

J. Racial and Ethnic Health Disparities

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Objective To assess overall and by neighborhood risk environments whether multilevel resilience resources were associated with HIV virologic suppression among African American/Black adults in the Southeastern United States. Setting and MethodsThis clinical cohort sub-study included 436 African American/Black participants enrolled in two parent HIV clinical cohorts. Resilience was assessed using the Multilevel Resilience Resource Measure (MRM) for African American/Black adults living with HIV, where endorsement of a MRM statement indicated agreement that a resilience resource helped a participant continue HIV care despite challenges or was present in a participant's neighborhood. Modified Poisson regression models estimated adjusted prevalence ratios (aPRs) for virologic suppression as a function of categorical MRM scores, controlling for demographic, clinical, and behavioral characteristics at or prior to sub-study enrollment. We assessed for effect measure modification (EMM) by neighborhood risk environments. Results Compared to participants with lesser endorsement of multilevel resilience resources, aPRs for virologic suppression among those with greater or moderate endorsement were 1.03 (95% confidence interval: 0.96-1.11) and 1.03 (0.96-1.11), respectively. Regarding multilevel resilience resource endorsement, there was no strong evidence for EMM by levels of neighborhood risk environments. Conclusions Modest positive associations between higher multilevel resilience resource endorsement and virologic suppression were at times most compatible with the data. However, null findings were also compatible. There was no strong evidence for EMM concerning multilevel resilience resource endorsement, which could have been due to random error. Prospective studies assessing EMM by levels of the neighborhood risk environment with larger sample sizes are needed.

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Section: Introductionmentioning

confidence: 99%

Multilevel Resilience and HIV Virologic Suppression Among African American/Black Adults in the Southeastern United States

Park

Wilson-Barthes

Dulin

et al. 2023

J. Racial and Ethnic Health Disparities

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“…This construct focuses on residents’ differential experiences and feelings of belonging. Among the 18 studies that assessed the composition and interaction in neighborhoods, four assessed its effect on ART initiation [ 67 , 71 , 79 , 96 ], none on ART adherence, 13 on HIV viral suppression [ 69 – 72 , 74 , 78 , 80 , 82 , 88 , 89 , 92 , 96 , 99 ], and three studies combined composition and interaction factors into a composite measure, making it difficult to examine the impact of each characteristic individually [ 68 , 75 , 87 ]. Three of the four studies on the associations with ART initiation found no association with Aboriginal residential density, [ 67 ] African American residential density [ 96 ], social cohesion, or social support [ 71 ].…”

Section: Resultsmentioning

confidence: 99%

“…Nine out of the thirteen studies found no association between HIV viral suppression and African American residential density [ 72 , 78 , 96 , 99 ], social capital [ 71 , 82 ], social cohesion [ 71 , 89 ], social support [ 71 ], and civic participation [ 88 ]. However, the remaining five studies found an inverse relationship between neighborhoods with higher percentages of African American residential density and HIV viral suppression [ 69 , 70 , 74 , 80 , 92 ].…”

Section: Resultsmentioning

confidence: 99%

“…This construct focuses on safety, and physical and social order. Among the 11 studies that assessed components of neighborhood disorder, one study assessed the effects of neighborhood disorder on ART initiation [ 98 ], 2 studies assessed the effects of disorder on ART adherence [ 71 , 95 ], and three studies assessed the effects of disorder on HIV viral suppression [ 70 , 76 , 80 , 82 , 88 , 91 , 92 , 95 , 99 ]. Shacham et al found that greater levels of perceived fear were associated with a lower likelihood of having a current combination antiretroviral therapy (cART) prescription [ 71 ] while Wright et al found higher crime was associated with lower adherence [ 95 ].…”

Section: Resultsmentioning

confidence: 99%

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Neighborhood characteristics and HIV treatment outcomes: A scoping review

Kimaru,

Habila,

Mantina

et al. 2024

PLOS Glob Public Health

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Recognizing challenges faced by people living with HIV is vital for improving their HIV treatment outcomes. While individual-level interventions play a crucial role, community factors can shape the impact of individual interventions on treatment outcomes. Understanding neighborhood characteristics’ association with HIV treatment outcomes is crucial for optimizing effectiveness. This review aims to summarize the research scope on the association between neighborhood characteristics and HIV treatment outcomes. The databases PubMed, CINAHL (EBSCOhost), Embase (Elsevier), and PsychINFO (EBSCOhost) were searched from the start of each database to Nov 21, 2022. Screening was performed by three independent reviewers. Full-text publications of all study design meeting inclusion criteria were included in the review. There were no language or geographical limitations. Conference proceedings, abstract only, and opinion reports were excluded from the review. The search yielded 7,822 publications, 35 of which met the criteria for inclusion in the review. Studies assessed the relationship between neighborhood-level disadvantage (n = 24), composition and interaction (n = 17), social-economic status (n = 18), deprivation (n = 16), disorder (n = 8), and rural-urban status (n = 7) and HIV treatment outcomes. The relationship between all neighborhood characteristics and HIV treatment outcomes was not consistent across studies. Only 7 studies found deprivation had a negative association with HIV treatment outcomes; 6 found that areas with specific racial/ethnic densities were associated with poor HIV treatment outcomes, and 5 showed that disorder was associated with poor HIV treatment outcomes. Three studies showed that rural residence was associated with improved HIV treatment outcomes. There were inconsistent findings regarding the association between neighborhood characteristics and HIV treatment outcomes. While the impact of neighborhood characteristics on disease outcomes is highly recognized, there is a paucity of standardized definitions and metrics for community characteristics to support a robust assessment of this hypothesis. Comparative studies that define and assess how specific neighborhood indicators independently or jointly affect HIV treatment outcomes are highly needed.

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“…Many PWH experience prominent structural vulnerabilities such as housing instability and food insecurity that should receive greater attention in biobehavioral research (87,156). These structural vulnerabilities are often embedded within distinct residential environments, and a burgeoning literature has focused on demonstrating the associations of neighborhood-level factors with health outcomes such as viral suppression (157)(158)(159). Advancing our understanding of multilevel determinants of microbiome-gut-brain axis alterations will guide the development of more comprehensive intervention approaches to address prevalent neuropsychiatric comorbidities and optimize health outcomes among PWH.…”

Section: Through the Looking-glass: Recommendations For Pni And Micro...mentioning

confidence: 99%

Through the Looking-Glass: Psychoneuroimmunology and the Microbiome-Gut-Brain Axis in the Modern Antiretroviral Therapy Era

et al. 2022

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Objective: Depression, substance use disorders, and other neuropsychiatric comorbidities are common in people with HIV (PWH), but the underlying mechanisms are not sufficiently understood. HIV-induced damage to the gastrointestinal tract potentiates residual immune dysregulation in PWH receiving effective antiretroviral therapy. However, few studies among PWH have examined the relevance of microbiomegut-brain axis: bidirectional crosstalk between the gastrointestinal tract, immune system, and central nervous system. Methods: A narrative review was conducted to integrate findings from 159 articles relevant to psychoneuroimmunology (PNI) and microbiome-gut-brain axis research in PWH. Results: Early PNI studies demonstrated that neuroendocrine signaling via the hypothalamic-pituitary-adrenal axis and autonomic nervous system could partially account for the associations of psychological factors with clinical HIV progression. This review highlights the need for PNI studies examining the mechanistic relevance of the gut microbiota for residual immune dysregulation, tryptophan catabolism, and oxytocin release as key biological determinants of neuropsychiatric comorbidities in PWH (i.e., body-to-mind pathways). It also underscores the continued relevance of neuroendocrine signaling via the hypothalamic-pituitary-adrenal axis, autonomic nervous system, and oxytocin release in modifying microbiome-gut-brain axis functioning (i.e., mind-to-body pathways). Conclusions: Advancing our understanding of PNI and microbiome-gut-brain axis pathways relevant to depression, substance use disorders, and other neuropsychiatric comorbidities in PWH can guide the development of novel biobehavioral interventions to optimize health outcomes. Recommendations are provided for biobehavioral and neurobehavioral research investigating bidirectional PNI and microbiomegut-brain axis pathways among PWH in the modern antiretroviral therapy era.

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Neighborhood Factors Associated with Racial/Ethnic Disparities in Achieving Sustained HIV Viral Suppression Among Miami-Dade County Ryan White Program Clients

Cited by 9 publications

References 41 publications

Multilevel Resilience and HIV Virologic Suppression Among African American/Black Adults in the Southeastern United States

Multilevel Resilience and HIV Virologic Suppression Among African American/Black Adults in the Southeastern United States

Neighborhood characteristics and HIV treatment outcomes: A scoping review

Through the Looking-Glass: Psychoneuroimmunology and the Microbiome-Gut-Brain Axis in the Modern Antiretroviral Therapy Era

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