The associations between neighborhood environments and HIV sexual risk behaviors among U.S. women are mixed, according to a new review led by Dr. Chanelle Howe, Assistant Professor of Epidemiology.
[Photo: Dr. Chanelle Howe]
A 2013 review of the literature regarding the relationship between neighborhood environment and engaging in risk behaviors for HIV infection found that various aspects of the neighborhood environment, including economic disadvantage and social cohesion, were positively or negatively associated with engaging in individual-level risk behaviors for HIV infection. It could be that these observed associations operate through psychological distress and stress. However, this review included studies primarily among men, drug users, and adolescents, so whether these associations hold when looking specifically at women is unknown.
To answer this important question, the researchers reviewed seven studies that included U.S. women who either did not have a recent history of drug use or had a recent history of drug use via non-injecting and/or injecting use. In some studies, neighborhood-level factors such as neighborhood disorder, urban versus rural residence, neighborhood violence, incarceration density, and victimization due to crime were associated with at least one risk behavior for HIV infection. However, in other studies there was no associations between neighborhood-level factors and risk behaviors.
The results of this study, published in AIDS and Behavior, are equivocal but clearly call for more rigorous work in this area. The researchers note that all of the studies included in the review were cross-sectional, whereas longitudinal studies may be better suited to explore the relationship between the neighborhood environment and risk behaviors over time.