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Neighborhood Social Capital in Relation to Late HIV Diagnosis, Linkage to HIV Care, and HIV Care Engagement

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      High neighborhood social capital could facilitate earlier diagnosis of HIV and higher rates of linkage and HIV care engagement. Multivariate analysis was used to examine whether social capital (social cohesion, social participation, and collective engagement) in 2004/2006 was associated with lower 5-year average (2007–2011) prevalence of (a) late HIV diagnosis, (b) linked to HIV care, and (c) engaged in HIV care within Philadelphia, PA, United States. Census tracts (N = 332). Higher average neighborhood social participation was associated with higher prevalence of late HIV diagnosis (b = 1.37, se = 0.32, p < 0.001), linked to HIV care (b = 1.13, se = 0.20, p < 0.001) and lower prevalence of engaged in HIV care (b = −1.16, se = 0.30, p < 0.001). Higher collective engagement was associated with lower prevalence of linked to HIV care (b = −0.62, se = 0.32, p < 0.05).The findings of different directions of associations among social capital indicators and HIV-related outcomes underscore the need for more nuanced research on the topic that include longitudinal assessment across key populations.


      Barrio alto de capital social podría facilitar el diagnóstico precoz del VIH y mayores tasas de vinculación y el compromiso de la atención del VIH. Se utilizó un análisis multivariado para examinar si capital social (cohesión social, la participación social y el compromiso colectivo) en 2004/2006 se asoció con una menor prevalencia promedio de 5 años (2007–2011) de (a) un diagnóstico tardío del VIH, (b) vinculado a la atención del VIH, y (c) que participan en la atención del VIH en Filadelfia, PA, Estados Unidos secciones censales (N = 332). Mayor participación social nota promedio se asoció con una mayor prevalencia de diagnóstico tardío del VIH (b = 1.37, SE = 0,32, p < 0,001), vinculado a la atención del VIH (b = 1.13, SE = 0,20, p < 0,001) y menor prevalencia de la dedicada a la atención del VIH (b = −1,16, SE = 0,30, p < 0,001). Compromiso colectivo se asoció con una menor prevalencia de vinculado a la atención del VIH (b = -0,62; SE = 0,32, p < 0,05). Los resultados de diferentes direcciones de las asociaciones entre los indicadores de capital social y los resultados relacionados con el VIH ponen de relieve la necesidad de una mayor matizada investigación sobre el tema que incluye evaluación longitudinal a través de poblaciones clave.

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        Antiretroviral therapy that reduces viral replication could limit the transmission of human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples. In nine countries, we enrolled 1763 couples in which one partner was HIV-1-positive and the other was HIV-1-negative; 54% of the subjects were from Africa, and 50% of infected partners were men. HIV-1-infected subjects with CD4 counts between 350 and 550 cells per cubic millimeter were randomly assigned in a 1:1 ratio to receive antiretroviral therapy either immediately (early therapy) or after a decline in the CD4 count or the onset of HIV-1-related symptoms (delayed therapy). The primary prevention end point was linked HIV-1 transmission in HIV-1-negative partners. The primary clinical end point was the earliest occurrence of pulmonary tuberculosis, severe bacterial infection, a World Health Organization stage 4 event, or death. As of February 21, 2011, a total of 39 HIV-1 transmissions were observed (incidence rate, 1.2 per 100 person-years; 95% confidence interval [CI], 0.9 to 1.7); of these, 28 were virologically linked to the infected partner (incidence rate, 0.9 per 100 person-years, 95% CI, 0.6 to 1.3). Of the 28 linked transmissions, only 1 occurred in the early-therapy group (hazard ratio, 0.04; 95% CI, 0.01 to 0.27; P<0.001). Subjects receiving early therapy had fewer treatment end points (hazard ratio, 0.59; 95% CI, 0.40 to 0.88; P=0.01). The early initiation of antiretroviral therapy reduced rates of sexual transmission of HIV-1 and clinical events, indicating both personal and public health benefits from such therapy. (Funded by the National Institute of Allergy and Infectious Diseases and others; HPTN 052 number, NCT00074581.).
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            Author and article information

            [1 ]ISNI 000000041936754X, GRID grid.38142.3c, Department of Social and Behavioral Sciences, , Harvard T.H. Chan School of Public Health, ; 677 Huntington Avenue, Kresge 7th Floor, Boston, MA 02115 USA
            [2 ]ISNI 0000 0001 2171 9311, GRID grid.21107.35, Department of Epidemiology, , Johns Hopkins Bloomberg School of Public Health, ; Baltimore, MD USA
            (617) 384-8814 ,
            AIDS Behav
            AIDS Behav
            AIDS and Behavior
            Springer US (New York )
            17 October 2016
            17 October 2016
            : 21
            : 3
            : 891-904
            © The Author(s) 2016

            Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

            Funded by: National Institutes of Health and National Cancer Institute
            Award ID: 1K01CA184288
            Award Recipient :
            Funded by: Johns Hopkins University Center for AIDS Research
            Award ID: P30A1094189
            Award Recipient :
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            © Springer Science+Business Media New York 2017


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