Changes in Alcohol Availability and HIV Rates

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DESCRIPTION (provided by applicant): Changes in Alcohol Availability and HIV/AIDS Risk Structural interventions considered relevant to reduce HIV/AIDS risk have been characterized in terms of a matrix (Blankenship, Bray et al. 2000). In 1997 the City of New Orleans adopted a series of policies (i.e., increased license fee, additional enforcement staff, expanded powers for the alcohol license board) that represent an organizational intervention to affect the accessibility of alcohol. As a structural intervention the policy changes in New Orleans can be studied in terms of their impact on HIV/AIDS risk. To accomplish this goal a longitudinal study of the effect of changes in alcohol accessibility on HIV/AIDS and gonorrhea risk is proposed. The specific aims are: Specific Aim 1. To develop a census tract level database for New Orleans and Baton Rouge tracts that incorporates spatially referenced data on HIV/AIDS risk (i.e., HARS data), gonorrhea risk (i.e. reported gonorrhea cases), alcohol availability (i.e., alcohol outlet density data), and sociodemographic risk (i.e. census data) for all tracts over a twelve year period (i.e., 1995 through 2006). Specific Aim 2. To conduct a pair of longitudinal analysis at the census tract level utilizing a repeated measures design of STD rates nested with census tracts (i.e., multilevel growth models) to assess the effect of the 1997 New Orleans alcohol policy changes on rates of HIV/AIDS and gonorrhea over a 12 year period. Controls for additional structural level predictors of risk as well as the effects of spatial and temporal autocorrelation will be addressed. Study Hypothesis 1: Among census tracts in New Orleans the trend in HIV/AIDS and gonorrhea rates over the study period will be more negative compared with census tracts in Baton Rouge. Study Hypothesis 2: Changes in alcohol outlet density at the census tract level will explain a significant amount of the trend in HIV/AIDS and gonorrhea rates over the study period.