Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Levy AR, et al. The direct costs of HIV/AIDS care. Lancet Infect Dis. 2006;6(3):171–7.

    PubMed  Google Scholar 

  2. Gillespie CD, Hurvitz KA. Prevalence of hypertension and controlled hypertension—United States, 2007–2010. MMWR Surveill Summ. 2013;62(Suppl 3):144–8.

    Google Scholar 

  3. Ali MK, et al. Characteristics associated with poor glycemic control among adults with self-reported diagnosed diabetes–National Health and Nutrition Examination Survey, United States, 2007–2010. MMWR Morb Mortal Wkly Rep. 2012;61:32–7.

    Google Scholar 

  4. Cohen MS, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Quinn TC, et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med. 2000;342(13):921–9.

    CAS  PubMed  Google Scholar 

  6. Muessig KE, Cohen MS. Advances in HIV prevention for serodiscordant couples. Curr HIV/AIDS Rep. 2014;11(4):434–46.

    PubMed  PubMed Central  Google Scholar 

  7. Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2015. HIV Surveillance Supplemental Report 2017;22(No. 2).

  8. Crepaz N, et al. Racial and ethnic disparities in sustained viral suppression and transmission risk potential among persons receiving HIV care—United States, 2014. MMWR Morb Mortal Wkly Rep. 2018;67(4):113–8.

    PubMed  PubMed Central  Google Scholar 

  9. Office of Disease Prevention and Health Promotion. Healthy People 2020. Diabetes: D-5.2 Proportion of the diabetic population with an A1c value less than 7 percent. https://www.healthypeople.gov/2020/data-search/Search-the-Data#objid=4124. Accessed 5 Dec 2019.

  10. Fryar CD, et al. Hypertension prevalence and control among adults: United States, 2015–2016. Hyattsville: National Center for Health Statistics; 2017.

    Google Scholar 

  11. DeNavas-Walt C, P. BD. Income and poverty in the United States: 2013. Washington, DC: U.S. Census Bureau, Current Population Reports, P60-249, 2014.

  12. Jargowsky P. Concentration of poverty in the new millennium: changes in prevalence, composition, and location of high poverty neighborhoods. The Century Foundation and Rutgers CURE; 2013.

  13. Jargowsky P. Architecture of segregation civil unrest, the concentration of poverty, and public policy. In: The Century Foundation; 2015.

  14. Bishaw A. Changes in areas with concentrated poverty: 2000 to 2010, in American Community Survey Reports. U.S. Census Bureau; 2014.

  15. Buys DR, et al. Association between neighborhood disadvantage and hypertension prevalence, awareness, treatment, and control in older adults: results from the University of Alabama at Birmingham Study of Aging. Am J Public Health. 2015;105(6):1181–8.

    PubMed  PubMed Central  Google Scholar 

  16. Kirby JB, Kaneda T. Neighborhood socioeconomic disadvantage and access to health care. J Health Soc Behav. 2005;46(1):15–31.

    PubMed  Google Scholar 

  17. Zierler S, et al. Economic deprivation and AIDS incidence in Massachusetts. Am J Public Health. 2000;90(7):1064–73.

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Joy R, et al. Impact of neighborhood-level socioeconomic status on HIV disease progression in a universal health care setting. J Acquir Immune Defic Syndr. 2008;47(4):500–5.

    PubMed  Google Scholar 

  19. McDavid Harrison K, et al. County-level socioeconomic status and survival after HIV diagnosis, United States. Ann Epidemiol. 2008;18(12):919–27.

    PubMed  Google Scholar 

  20. Cubbin C, Winkleby MA. Protective and harmful effects of neighborhood-level deprivation on individual-level health knowledge, behavior changes, and risk of coronary heart disease. Am J Epidemiol. 2005;162(6):559–68.

    PubMed  Google Scholar 

  21. Gaskin DJ, et al. Disparities in diabetes: the nexus of race, poverty, and place. Am J Public Health. 2014;104(11):2147–55.

    PubMed  PubMed Central  Google Scholar 

  22. Gant Z, et al. A census tract-level examination of social determinants of health among black/African American men with diagnosed HIV infection, 2005–2009—17 US areas. PLoS ONE. 2014;9(9):e107701.

    PubMed  PubMed Central  Google Scholar 

  23. Vaughan AS, et al. Connecting race and place: a county-level analysis of White, Black, and Hispanic HIV prevalence, poverty, and level of urbanization. Am J Public Health. 2014;104(7):e77–84.

    PubMed  PubMed Central  Google Scholar 

  24. Morenoff JD, et al. Understanding social disparities in hypertension prevalence, awareness, treatment, and control: the role of neighborhood context. Soc Sci Med. 2007;65(9):1853–66.

    PubMed  PubMed Central  Google Scholar 

  25. Laraia BA, et al. Place matters: neighborhood deprivation and cardiometabolic risk factors in the Diabetes Study of Northern California (DISTANCE). Soc Sci Med. 2012;74(7):1082–90.

    PubMed  PubMed Central  Google Scholar 

  26. Wiewel EW, et al. Neighborhood characteristics associated with achievement and maintenance of HIV Viral suppression among persons newly diagnosed with HIV in New York city. AIDS Behav. 2017;21(12):3557–66.

    PubMed  Google Scholar 

  27. Diez Roux AV. Investigating neighborhood and area effects on health. Am J Public Health. 2001;91(11):1783–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Yen IH, Syme SL. The social environment and health: a discussion of the epidemiologic literature. Annu Rev Public Health. 1999;20:287–308.

    CAS  PubMed  Google Scholar 

  29. Kwarteng JL, et al. Independent effects of neighborhood poverty and psychosocial stress on obesity over time. J Urban Health. 2017;94(6):791–802.

    PubMed  PubMed Central  Google Scholar 

  30. Barkan SE, et al. The Women’s Interagency HIV Study. WIHS Collaborative Study Group. Epidemiology. 1998;9(2):117–25.

    CAS  PubMed  Google Scholar 

  31. Bacon MC, et al. The Women’s Interagency HIV Study: an observational cohort brings clinical sciences to the bench. Clin Diagn Lab Immunol. 2005;12(9):1013–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Hessol NA, et al. Retention and attendance of women enrolled in a large prospective study of HIV-1 in the United States. J Womens Health (Larchmt). 2009;18(10):1627–37.

    Google Scholar 

  33. Tien PC, et al. Association of HIV infection with incident diabetes mellitus: impact of using hemoglobin A1C as a criterion for diabetes. J Acquir Immune Defic Syndr. 2012;61(3):334–40.

    CAS  PubMed  PubMed Central  Google Scholar 

  34. Khalsa A, et al. Correlates of prevalent hypertension in a large cohort of HIV-infected women: Women’s Interagency HIV Study. AIDS. 2007;21(18):2539–41.

    PubMed  Google Scholar 

  35. Yi T, et al. The impact of the AIDS Drug Assistance Program (ADAP) on use of highly active antiretroviral and antihypertensive therapy among HIV-infected women. J Acquir Immune Defic Syndr. 2011;56(3):253–62.

    CAS  PubMed  PubMed Central  Google Scholar 

  36. A compass for understanding and using american community survey data: what general data users need to know. U.S. Census Bureau: Washington, DC; 2008.

  37. Krieger N. A century of census tracts: health & the body politic (1906–2006). J Urban Health. 2006;83(3):355–61.

    PubMed  PubMed Central  Google Scholar 

  38. United States Census Bureau. “Table B17020”. 2010–2014 American Community Survey. U.S. Census Bureau’s American Community Survey Office, 2015. https://factfinder.census.gov. Accessed 1 Mar 2016.

  39. Jargowsky P. Studying neighborhood poverty, in povety and place: ghettos, barrios, and the American City. New York: Russell Sage Foundation; 1997.

    Google Scholar 

  40. Okura Y, et al. Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. J Clin Epidemiol. 2004;57(10):1096–103.

    PubMed  Google Scholar 

  41. Boudreau DM, et al. A validation study of patient interview data and pharmacy records for antihypertensive, statin, and antidepressant medication use among older women. Am J Epidemiol. 2004;159(3):308–17.

    PubMed  Google Scholar 

  42. Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159(7):702–6.

    PubMed  Google Scholar 

  43. Greenland S, Pearl J, Robins JM. Causal diagrams for epidemiologic research. Epidemiology. 1999;10(1):37–48.

    CAS  PubMed  Google Scholar 

  44. Mayer VL, McDonough K, Seligman H, Mitra N, Long JA. Food insecurity, coping strategies and glucose control in low-income patients with diabetes. Public Health Nutr. 2016;19(6):1103–11.

    PubMed  Google Scholar 

  45. Aggarwal A, Monsivais P, Drewnowski A. Nutrient intakes linked to better health outcomes are associated with higher diet costs in the US. PLoS ONE. 2012;7(5):e37533.

    CAS  PubMed  PubMed Central  Google Scholar 

  46. Adimora AA, et al. Heterosexually transmitted HIV infection among African Americans in North Carolina. J Acquir Immune Defic Syndr. 2006;41(5):616–23.

    PubMed  Google Scholar 

  47. Denning P, DiNenno E. Communities in crisis: is there a generalized HIV epidemicin impoverished urban areas of the United States? Presented at: XVIII International AIDS Conference; July 16–19, 2010; Vienna, Austria.

  48. Kahana SY, et al. Structural determinants of antiretroviral therapy use, HIV care attendance, and viral suppression among adolescents and young adults living with HIV. PLoS ONE. 2016;11(4):e0151106.

    PubMed  PubMed Central  Google Scholar 

  49. Adimora AA, et al. Policies and politics that promote HIV infection in the Southern United States. AIDS. 2014;28(10):1393–7.

    PubMed  PubMed Central  Google Scholar 

  50. National Alliance of State and Territorial AIDS Directors. National ADAP Monitoring Project Annual Report. https://www.nastad.org/sites/default/files/NASTAD-ADAP-Monitoring-Project-Annual-Report-May-2015.pdf. Accessed 3 Jan 2016.

  51. Adimora AA, et al. Cohort profile: the Women’s Interagency HIV Study (WIHS). Int J Epidemiol. 2018;47(2):393–4.

    PubMed  PubMed Central  Google Scholar 

  52. Meditz AL, et al. Sex, race, and geographic region influence clinical outcomes following primary HIV-1 infection. J Infect Dis. 2011;203(4):442–51.

    PubMed  PubMed Central  Google Scholar 

  53. Lesko CR, et al. Ten-year survival by race/ethnicity and sex among treated, HIV-infected adults in the United States. Clin Infect Dis. 2015;60(11):1700–7.

    PubMed  PubMed Central  Google Scholar 

  54. Fowler CS, et al. Who are the people in my neighborhood?: The “contextual fallacy” of measuring individual context with census geographies. Geographical Analysis, 2019. [Epub ahead of print].

  55. US Census Bureau. 2010 geographic terms and concepts—census tract. Last Revised September 16, 2019. https://www.census.gov/programs-surveys/geography/about/glossary.html#par_textimage_13. Accessed 7 Oct 2019.

  56. Kneebone, E., The Growth and Spread of Concentrated Poverty, 2000 to 2008–2012. Brookings Institute; 2014. https://www.brookings.edu/interactives/the-growth-and-spread-of-concentrated-poverty-2000-to-2008-2012/. Accessed 3 Dec 2018.

Download references

Funding

Data in this manuscript were collected by the Women’s Interagency HIV Study (WIHS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). WIHS (Principal Investigators): UAB-MS WIHS (Mirjam-Colette Kempf and Deborah Konkle-Parker), U01-AI-103401; Atlanta WIHS (Ighovwerha Ofotokun, Anandi, Sheth, and Gina Wingood), U01-AI-103408; Bronx WIHS (Kathryn Anastos and Anjali Sharma), U01-AI-035004; Brooklyn WIHS (Deborah Gustafson and Tracey Wilson), U01-AI-031834; Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; Metropolitan Washington WIHS (Seble Kassaye and Daniel Merenstein), U01-AI-034994; Miami WIHS (Maria Alcaide, Margaret Fischl, and Deborah Jones), U01-AI-103397; UNC WIHS (Adaora Adimora), U01-AI-103390; Connie Wofsy Women’s HIV Study, Northern California (Bradley Aouizerat and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590; Southern California WIHS (Joel Milam), U01-HD-032632 (WIHS I–WIHS IV). The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women’s Health. WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA), UL1-TR000454 (Atlanta CTSA), P30-AI-050410 (UNC CFAR), and P30-AI-027767 (UAB CFAR).

Author information

Authors and Affiliations

  1. Division of Infectious Diseases, School of Medicine, University of North Carolina, Bioinformatics, Campus Box 7030, Chapel Hill, NC, 27599-7030, USA

    Anna B. Cope, Christina Ludema, Joseph J. Eron & Adaora A. Adimora

  2. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Andrew Edmonds, Stephen R. Cole & Adaora A. Adimora

  3. Department of Epidemiology and Biostatistics, School of Public Health, Indiana University at Bloomington, Bloomington, IN, USA

    Christina Ludema

  4. Departments of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA

    Kathryn Anastos

  5. Department of Clinical Pharmacy, University of California San Francisco School of Pharmacy, San Francisco, CA, USA

    Jennifer Cocohoba

  6. Department of Medicine, Cook County Health and Hospital System and Rush University, Chicago, IL, USA

    Mardge Cohen

  7. Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, USA

    Igho Ofotokun

  8. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Elizabeth T. Golub

  9. Division of Infectious Diseases and Travel Medicine, Department of Medicine, Georgetown University, Washington, DC, USA

    Seble Kassaye

  10. Division of Infectious Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA

    Deborah Konkle-Parker

  11. Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA

    Lisa R. Metsch

  12. Department of Community Health Sciences, School of Public Health, State University of New York Downstate Medical Center, Brooklyn, NY, USA

    Tracey E. Wilson

Authors
  1. Anna B. Cope
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew Edmonds
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christina Ludema
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stephen R. Cole
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joseph J. Eron
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kathryn Anastos
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jennifer Cocohoba
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mardge Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Igho Ofotokun
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Elizabeth T. Golub
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Seble Kassaye
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Deborah Konkle-Parker
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Lisa R. Metsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Tracey E. Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Adaora A. Adimora
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anna B. Cope.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 28 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cope, A.B., Edmonds, A., Ludema, C. et al. Neighborhood Poverty and Control of HIV, Hypertension, and Diabetes in the Women’s Interagency HIV Study. AIDS Behav 24, 2033–2044 (2020). https://doi.org/10.1007/s10461-019-02757-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-019-02757-5

Keywords

Search

Navigation