Short communicationConsidering high alcohol and violence neighborhood context using daily diaries and GPS: A pilot study among people living with HIV
Section snippets
Background
Although antiretroviral therapy (ART) has greatly reduced HIV-related morbidity and mortality (Palella et al., 2006), benefits of therapy require strict adherence, tolerance of side effects, and regular access to primary care (Celum et al., 2013; Lima et al., 2007). Retention in care among PLWH is low in the U.S. (Marks et al., 2010), and 30% or less achieve successful viral suppression (CDC, 2011; Gardner et al., 2011). There is also substantial geographic variability and potential regional
Methods
A parent study was underway in an urban metropolitan region in the Southeast to examine the impact of early life and adult stress on biological and clinical outcomes of PLWH over 2.5 years (N = 350). The goal of the parent cohort is to examine the impact of early life and adult stress on biological and clinical outcomes of PLWH over 2.5 years. From October 2015 to October 2017, a small random sample of participants who consented to the parent study were invited to participate in this additional
Results
Almost half (45%) of participants in this small pilot study (N = 11) were female, and 90% identified as Black. On average, the participants spent 19% of their time awake during the 2-week periods in their residential census tract. Participants traversed an average of 23 census tracts over this period. They were exposed to neighborhood violent crime rates that varied from 1 to 28 per 1,000 population and off-site alcohol density rates of 0–22 per 1,000 depending on the census tract. The average
Discussion
This study fits within a broader effort in the study of health and place to document the multiple contexts that individuals inhabit and the ways they move across contexts throughout the day. Results demonstrate the feasibility of this methodology (GPS coupled with a daily diary captured via SMS messaging) among PLWH. Furthermore, as demonstrated in previous studies (Byrnes et al., 2015), there were meaningful differences in exposure context comparing activity space to residential contexts.
Conflict of interest
There are no conflicts of interest to report.
Contributors
KPT and DJW conceptualized the study. EFK and XZ conducted data collection. Data analysis was conducted by EFK, MW, CM, and KPT. KPT wrote the manuscript with feedback provided by all co-authors. All authors have contributed to and approved the final manuscript
Role of funding source
No form of payment was given to anyone to produce the manuscript.
Acknowledgments
This study was supported by the National Institutes on Alcohol Abuse and Alcoholism(NIAAA) (P60AA009803). This study was approved by two university Institutional Review Boards. The authors thank all of the participants who agreed to take part in this study.
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