Year: 2026
Type: article
Study design: Observational Study
Abstract: Neighborhood violence and safety concerns are associated with poor health outcomes including HIV acquisition/transmission, and possible lack of viral suppression. Using a cross-sectional analytic design, we determined the prevalence of neighbourhood violence and safety concerns among participants in the MACS WIHS Combined Cohort Study, a large US cohort of men and women with and without HIV. We used multivariable logistic regression to assess factors associated with perceptions of neighborhood violence (weapon and gang fights, sexual assault, robbery or mugging) and safety concerns (feeling safe walking at night). Most participants perceived their neighborhoods as violent (59%) and unsafe (69%). Black participants, women, those with lower income, less formal education, substance use, and those with higher levels of stress, depressive symptoms, and frailty scores had greater odds of perceiving neighborhood violence and safety concerns. Among women, those who missed ≥1 HIV clinic appointment were twice as likely to report their neighborhoods as unsafe. Women reporting marijuana use (OR 1.29, 95% CI: 1.00, 1.646) or meeting the definition for frailty (OR 1.37, 95% CI: 1.04, 1.83) reported higher odds of neighborhood violence. Among men, smoking or substance use were associated with higher odds of perceiving violence and safety concerns. Men with depressive symptoms were more than twice as likely to report neighborhood safety concerns than men without symptoms. The intersection of previous HIV-related risk factors and reported neighborhood violence and safety emerged as highly significant and warrants efforts to better understand and address structural challenges to comprehensive care for people with HIV.
Source: AIDS and Behavior
Institutions: John H. Stroger, Jr. Hospital of Cook County, Cook County Health and Hospitals System, Hektoen Institute, University of Pittsburgh, Johns Hopkins University, Albert Einstein College of Medicine, University of Miami, University of Alabama at Birmingham, Whitman-Walker Health, Georgetown University, University of California, Los Angeles, University of North Carolina at Chapel Hill, Emory University, Northwestern University, University of California, San Francisco, SUNY Downstate Health Sciences University
Language: English
Topic: HIV, Drug Use, Sexual Risk
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,590
Funders: Indiana Clinical and Translational Sciences Institute, Mucolipidosis IV Foundation, Georgia Clinical and Translational Science Alliance, National Institutes of Health, University of California, San Francisco, Center for AIDS Research, University of Alabama at Birmingham, National Institute on Alcohol Abuse and Alcoholism, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute on Drug Abuse, National Institute on Deafness and Other Communication Disorders, National Institute of Nursing Research, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, National Institute of Dental and Craniofacial Research, National Center for Advancing Translational Sciences, National Institute on Minority Health and Health Disparities, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Center for AIDS Research, University of North Carolina at Chapel Hill, Clinical and Translational Science Institute, University of California, Los Angeles
Awards: G1034546755, G1296759572, G1787625665, G1849940085, G1972383081, G2008237588, G2255252254, G2262636591, G2542587862, G255204022, G2684128596, G2908277772, G3102910958, G311558797, G319781266, G3630727822, G3869857964, G3942807564, G4016133911, G4361283536, G4391827178, G4535678174, G456742281, G4584981698, G474620922, G4844376359, G5078796989, G521591464, G5249024608, G5512195800, G562934659, G5691055145, G5699974340, G5704690338, G6068496172, G6384504179, G6509896931, G6745172908, G6990385686, G7001360886, G7627181020, G775892330, G7760075911, G7807729167, Johns Hopkins Institute for Clinical and Translational Research, G8448522485, G9000016284, G9000030090, G9000030772, G9000031392, G9000034708, G9000039899, G9000041916, G9000080293, G9000082816, G9000099115, G9000102070, G9000108991, G9000146713, G9000310595, MACS/WIHS Combined Cohort Study: Brooklyn Clinical Research Site (Bklyn CRS)
OpenAlex ID: W7168518046