Neighborhood Characteristics, Intersectional Discrimination, Mental Health, and HIV Outcomes Among Black Women Living With HIV, Southeastern United States, 2019‒2020

Author:

Wright Ian A.1,Reid Rachelle1,Shahid Naysha1,Ponce Amanda1,Nelson C. Mindy1,Sanders Jasmyn1,Gardner Nadine1,Liu Jingxin1,Simmons Ervin1,Phillips Arnetta1,Pan Yue1,Alcaide Maria L.1,Rodriguez Allan1,Ironson Gail1,Feaster Daniel J.1,Safren Steven A.1,Dale Sannisha K.1

Affiliation:

1. Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine....

Abstract

Objectives. To examine the effects of within-neighborhood and neighboring characteristics on discrimination, stigma, mental health, and HIV outcomes among Black women living with HIV (BWLWH). Methods. A total of 151 BWLWH in a southeastern US city provided baseline data (October 2019‒January 2020) on experienced microaggressions and discrimination (race-, gender-, sexual orientation-, or HIV-related), mental health (e.g., depression, posttraumatic stress disorder), and HIV outcomes (e.g., viral load, antiretroviral therapy adherence). Neighborhood characteristics by census tract were gathered from the American Community Survey and the National Center for Charitable Statistics. Spatial econometrics guided the identification strategy, and we used the maximum likelihood technique to estimate relationships between a number of predictors and outcomes. Results. Within-neighborhood and neighboring characteristics (employment, education, crime, income, number of religious organizations, and low-income housing) were significantly related to intersectional stigma, discrimination, mental health, HIV viral load, and medication adherence. Conclusions. Policy, research, and interventions for BWLWH need to address the role of neighborhood characteristics to improve quality of life and HIV outcomes. (Am J Public Health. 2022;112(S4):S433–S443. https://doi.org/10.2105/AJPH.2021.306675 )

Publisher

American Public Health Association

Subject

Public Health, Environmental and Occupational Health

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