Neighborhood community characteristics associated with HIV disease outcomes in a cohort of urban women living with HIV.
Neighborhood community characteristics associated with HIV disease outcomes in a cohort of urban women living with HIV.
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DOI：
10.1080/09540121.2016.1173642
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发表时间：
2016-10
期刊：
影响因子：
1.7
通讯作者：
Cohen MH
中科院分区：
文献类型：
--
作者：
Burke-Miller JK;Weber K;Cohn SE;Hershow RC;Sha BE;French AL;Cohen MH
最近的研究发现，免疫和病毒性艾滋病结果的地理差异与人口普查对社区贫困和隔离的衡量有关。虽然很容易获得，但这种总人口普查措施不是基于健康行为模型，并提供有限的信息，关于邻里效应途径。相比之下，基于调查的措施可以捕捉邻里劣势的具体方面，可以更好地为基于社区的干预措施提供信息。因此，本研究的目的是评估的测量有效性的多维调查措施的邻里障碍相比，人口普查措施作为艾滋病毒的结果在一个队列的197个低收入妇女在一个主要的大都市地区的预测。多层面调查措施相互关联，并与人口普查中集中贫困和种族隔离的措施相关，但相关性不高，不统一。我们发现社区之间妇女的CD4水平有显着的变化，但没有相应的地理差异，病毒载量，社区面积的措施和病毒载量之间的关系消失后，调整个人特征，包括艾滋病毒治疗依从性。在调整了个体特征（包括物质使用、抑郁和艾滋病毒治疗依从性）的多水平模型中，一项邻里劣势调查指标（建筑环境质量差）和一项人口普查指标（种族隔离）与CD4 <500的可能性显著相关（p <0.05）。
Recent studies have found geographic variations in immune and viral HIV disease outcomes associated with Census measures of neighborhood poverty and segregation. Although readily available, such aggregate Census measures are not based on health behavior models and provide limited information regarding neighborhood effect pathways. In contrast, survey-based measures can capture specific aspects of neighborhood disadvantage that may better inform community-based interventions. Therefore, the aim of this study is to assess the measurement validity of multi-dimensional survey measures of neighborhood disorder compared with Census measures as predictors of HIV outcomes in a cohort of 197 low-income women in a major metropolitan area. The multidimensional survey measures were related to each other and to Census measures of concentrated poverty and racial segregation, but not so highly correlated as to be uniform. We found notable variation between community areas in women’s CD4 levels but there was no corresponding geographic variance in viral load, and relationships between community area measures and viral load disappeared after adjustment for individual characteristics, including HIV treatment adherence. In multilevel models adjusting for individual characteristics including substance use, depression and HIV treatment adherence, one survey measure of neighborhood disadvantage (poor quality built environment) and one Census measure (racial segregation) were significantly associated with greater likelihood of CD4<500 (p<.05).
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影响因子：
3.8
作者：
Cook, Judith A.;Burke-Miller, Jane K.;Cohen, Mardge H.;Cook, Robert L.;Vlahov, David;Wilson, Tracey E.;Golub, Elizabeth T.;Schwartz, Rebecca M.;Howard, Andrea A.;Ponath, Claudia;Plankey, Michael W.;Levine, Andrea;Grey, Dennis D.
通讯作者：
Grey, Dennis D.
影响因子：
5
作者：
Mujahid, Mahasin S.;Roux, Ana V. Diez;Raghunathan, Trivellore
通讯作者：
Raghunathan, Trivellore
影响因子：
4.4
作者：
Morenoff, JD
通讯作者：
Morenoff, JD
影响因子：
5.4
作者：
Barkan, SE;Melnick, SL;Feldman, J
通讯作者：
Feldman, J
DOI：
10.1097/00042560-200208010-00005
发表时间：
2002-08-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
Cook, JA;Cohen, MH;Young, M
通讯作者：
Young, M