Ann Epidemiol

IntroductionNeighborhood characteristics shape sexual risk in HIV-uninfected adults in the United States (US). We assess relationships between census tract characteristics and sexual risk behaviors in a predominantly HIV-infected cohort of women living in the Southern US.MethodsThis cross-sectional multilevel analysis included data from 737 HIV-infected and HIV-uninfected women enrolled in the Women\u2019s Interagency HIV Study. Administrative data captured characteristics of census tracts where women lived; participant-level data were gathered via survey. We used principal components analysis to condense tract-level variables into components: social disorder (e.g., violent crime rate) and social disadvantage (e.g., alcohol outlet density). We used hierarchical generalized linear models to assess relationships between tract-level characteristics and condomless vaginal intercourse (CVI), anal intercourse (AI), and condomless anal intercourse (CAI).ResultsGreater social disorder was associated with less AI (OR=0.63, 95% CI=0.43, 0.94) and CAI (OR=0.49, 95% CI=0.30, 0.80), regardless of HIV status. There were no statistically significant additive or multiplicative interactions between tract characteristics and HIV status.ConclusionNeighborhood characteristics are associated with sexual risk behaviors among women living in the Southern US, these relationships do not vary by HIV status. Future studies should establish temporality and explore the causal pathways through which neighborhoods influence sexual risk.20172018-04-10T00:00:00ZP30 AI050409/AI/NIAID NIH HHS/United StatesU01 AI103397/AI/NIAID NIH HHS/United StatesK01 HD074726/HD/NICHD NIH HHS/United StatesU01 PS003315/PS/NCHHSTP CDC HHS/United StatesUL1 TR000454/TR/NCATS NIH HHS/United StatesU01 AI103401/AI/NIAID NIH HHS/United StatesF31 MH105238/MH/NIMH NIH HHS/United StatesU01 AI103390/AI/NIAID NIH HHS/United StatesU01 AI103408/AI/NIAID NIH HHS/United StatesU01 AI042590/AI/NIAID NIH HHS/United States28476327PMC5502822671