Does Place Matter?: An Examination of Neighborhood Disadvantage and HIV Risk

Leah Maria Adams

Advisor: June P Tangney, PhD, Department of Psychology

Committee Members: Todd Kashdan, Lisa Lindley

David J. King Hall, #2013
May 15, 2013, 12:00 AM to 06:00 AM


A systematic review of neighborhood influences on HIV risk behaviors was conducted with a focus on 1) the various conceptualizations of neighborhood, 2) the net findings regarding neighborhood effects on HIV risk, and 3) an evaluation of the samples’ generalizability. Neighborhood characteristics were associated with HIV risk, including drug and sex-related behaviors, independent of individual characteristics. However, these relationships varied by time. While early studies have most often found that greater neighborhood disadvantage was related to greater HIV risk, recent work has found the opposite association, possibly indicating that prior prevention efforts in these “at-risk” areas have been effective. 

The relationship between neighborhood disadvantage and HIV risk was also investigated in a sample of 236 former jail inmates, a group at elevated risk for the disease. Controlling for individual demographic characteristics, neighborhood disadvantage was negatively associated with injection drug use, unprotected sex with non-primary partners, and overall HIV risk; there was a non-significant positive association between neighborhood disadvantage and number of sexual partners. Taken together, these findings lend support to the effectiveness of HIV prevention messages targeted to disadvantaged neighborhoods, and suggest that greater attention to HIV risk and prevention in suburban, affluent communities may be warranted.