TY - JOUR
T1 - Associations between population density and clinical and sociodemographic factors in women living with HIV in the Southern United States
AU - Edmonds, Andrew
AU - Haley, Danielle F.
AU - Tong, Weiqun
AU - Kempf, Mirjam Colette
AU - Rahangdale, Lisa
AU - Adimora, Adaora A.
AU - Anastos, Kathryn
AU - Cohen, Mardge H.
AU - Fischl, Margaret
AU - Wilson, Tracey E.
AU - Wingood, Gina
AU - Konkle-Parker, Deborah
N1 - Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - To explore the associations of urbanicity with clinical/behavioral outcomes and sociodemographic factors among women living with HIV in the Southern United States, 523 participants of the Women’s Interagency HIV Study were classified into population density quartiles. Rural-Urban Commuting Area codes revealed that 7% resided in areas where >30% commute to urban areas, 2% resided in small towns or rural areas, and 91% resided in varying densities of urban areas. Although women in lower density, mostly suburban areas reported higher socioeconomic indicators such as advanced education and greater annual household income, larger proportions of women in the lowest density quartile perceived discrimination in health care settings and agreed with several internalized HIV stigma scale items. Women in the lower quartiles had higher CD4 counts, while those in the lowest quartile were more likely to have a suppressed HIV viral load, report being employed, and not report a history of drug use or current heavy alcohol use. More research is needed to understand the interplay between population density and mechanisms contributing to HIV control as well as increased internalized stigma and perceived discrimination, along with how to target interventions to improve outcomes for individuals with HIV across urban, suburban, and rural areas.
AB - To explore the associations of urbanicity with clinical/behavioral outcomes and sociodemographic factors among women living with HIV in the Southern United States, 523 participants of the Women’s Interagency HIV Study were classified into population density quartiles. Rural-Urban Commuting Area codes revealed that 7% resided in areas where >30% commute to urban areas, 2% resided in small towns or rural areas, and 91% resided in varying densities of urban areas. Although women in lower density, mostly suburban areas reported higher socioeconomic indicators such as advanced education and greater annual household income, larger proportions of women in the lowest density quartile perceived discrimination in health care settings and agreed with several internalized HIV stigma scale items. Women in the lower quartiles had higher CD4 counts, while those in the lowest quartile were more likely to have a suppressed HIV viral load, report being employed, and not report a history of drug use or current heavy alcohol use. More research is needed to understand the interplay between population density and mechanisms contributing to HIV control as well as increased internalized stigma and perceived discrimination, along with how to target interventions to improve outcomes for individuals with HIV across urban, suburban, and rural areas.
KW - Population density
KW - Southern US
KW - clinical outcomes
KW - stigma
UR - http://www.scopus.com/inward/record.url?scp=85086044135&partnerID=8YFLogxK
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U2 - 10.1080/09540121.2020.1769829
DO - 10.1080/09540121.2020.1769829
M3 - Article
C2 - 32449377
AN - SCOPUS:85086044135
SN - 0954-0121
VL - 33
SP - 229
EP - 238
JO - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
JF - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
IS - 2
ER -