Neighborhoods and HIV: A social ecological approach to prevention and care.

Abstract

Neighborhood factors have been linked to HIV risk behaviors, HIV counseling and testing, and HIV medical care. However, the social–psychological mechanisms that connect neighborhood factors to HIV-related behaviors have not been fully determined. In this paper we review the research on neighborhood factors and HIV-related behaviors, approaches to measuring neighborhoods, and mechanism that may help to explain how the physical and social environment within neighborhoods may lead to HIV related behaviors. We then discuss organizational, geographic, and social network approaches to intervene in neighborhoods to reduce HIV transmission and facilitate HIV medical care with the goal of reducing morbidity and mortality and increasing social and psychological well-being.

Material Deprivation Affects High Sexual Risk Behavior among Young People in Urban Slums, South Africa

“…Additionally, the findings support the argument from previous studies that 14,20 There is an urgent need for locally appropriate behavioral HIV prevention interventions to engage with housing, food, and healthcare needs among young people in urban slums.…”

“…3,5,7,[12][13][14][15][16] The bulk of this research has assessed broad measures of economic deprivation-such as income, employment, education or lack of access to opportunity structures-to predict the likelihood of slum residents, particularly women and girls, in sexual risk taking. While this research is valuable, increasingly attention in sub-Saharan Africa has been devoted to predicting sexual risk taking using critical aspects of urban poverty that best represents individuals' living experiences.…”

Measurement of Neighborhood Context in an Urban Cohort of HIV-Infected or at Risk Low-Income Women

“…Department of Health and Human Services, 2011; Diez-Roux, 2008; Berkman & Kawachi, 2003), including policies and interventions targeting neighborhoods and health (Braveman et al, 2011). The influence of where people live on their health, independent of individual factors, is well established in areas such as chronic disease morbidity and mortality, cardiovascular disease, mental illness, birth outcomes, infant health, HIV transmission risk, and racial health disparities (Berkman & Kawachi, 2003; Diez-Roux, 2007; Latkin et al, 2013; LaVeist et al, 2011). …”

“…Although readily available, such aggregate Census measures are not based on theoretical models and provide limited information regarding neighborhood effect pathways (Diez-Roux, 2008; Latkin et al, 2013; Sampson & Graif, 2009). In addition, aggregate census data by nature applies homogenous values such as poverty or deprivation to local areas that may be heterogeneous in meaningful ways such as social capital and community resilience (Snowden & Yamada, 2005).…”

“…In addition, aggregate census data by nature applies homogenous values such as poverty or deprivation to local areas that may be heterogeneous in meaningful ways such as social capital and community resilience (Snowden & Yamada, 2005). Improvement of neighborhood context measures would enable social epidemiology to move from a focus on the intersection of race, poverty, and locality in relationship to health and on to examining local area variations among distressed or at risk populations thereby identifying processes that may be amenable to community-based interventions (Geronimus, 2000; Poundstone et al, 2004; Latkin et al, 2013). To date, non-census based neighborhood measurement methodology has been limited and inadequately reported, hindering cross-study comparisons and measurement refinement (Diez-Roux & Mair, 2010; Merlo et al, 2009; Pruitt et al, 2010; Pruchno et al, 2011).…”