Neighborhood Poverty and Control of HIV, Hypertension, and Diabetes in the Women’s Interagency HIV Study

Anna B. Cope, Andrew Edmonds, Christina Ludema, Stephen R. Cole, Joseph J. Eron, Kathryn Anastos, Jennifer Cocohoba, Mardge Cohen, Igho Ofotokun, Elizabeth T. Golub, Seble Kassaye, Deborah Konkle-Parker, Lisa R. Metsch, Tracey E. Wilson, Adaora A. Adimora

Research output: Contribution to journalArticle

Abstract

Neighborhoods with high poverty rates have limited resources to support residents’ health. Using census data, we calculated the proportion of each Women’s Interagency HIV Study participant’s census tract (neighborhood) living below the poverty line. We assessed associations between neighborhood poverty and (1) unsuppressed viral load [VL] in HIV-seropositive women, (2) uncontrolled blood pressure among HIV-seropositive and HIV-seronegative hypertensive women, and (3) uncontrolled diabetes among HIV-seropositive and HIV-seronegative diabetic women using modified Poisson regression models. Neighborhood poverty was associated with unsuppressed VL in HIV-seropositive women (> 40% versus ≤ 20% poverty adjusted prevalence ratio (PR), 1.42; 95% confidence interval (CI) 1.04–1.92). In HIV-seronegative diabetic women, moderate neighborhood poverty was associated with uncontrolled diabetes (20–40% versus ≤ 20% poverty adjusted PR, 1.75; 95% CI 1.02–2.98). Neighborhood poverty was associated with neither uncontrolled diabetes among HIV-seropositive diabetic women, nor uncontrolled hypertension in hypertensive women, regardless of HIV status. Women living in areas with concentrated poverty may need additional resources to control health conditions effectively.

Original languageEnglish (US)
Pages (from-to)2033-2044
Number of pages12
JournalAIDS and Behavior
Volume24
Issue number7
DOIs
StatePublished - Jul 1 2020

Keywords

  • Blood pressure
  • Census tract
  • Contextual poverty
  • Health disparity
  • Viral suppression

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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    Cope, A. B., Edmonds, A., Ludema, C., Cole, S. R., Eron, J. J., Anastos, K., Cocohoba, J., Cohen, M., Ofotokun, I., Golub, E. T., Kassaye, S., Konkle-Parker, D., Metsch, L. R., Wilson, T. E., & Adimora, A. A. (2020). Neighborhood Poverty and Control of HIV, Hypertension, and Diabetes in the Women’s Interagency HIV Study. AIDS and Behavior, 24(7), 2033-2044. https://doi.org/10.1007/s10461-019-02757-5