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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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          Abstract

          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.

          Resumen

          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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          Most cited references63

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          GeoDa: An Introduction to Spatial Data Analysis

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            A systematic review of the relationships between social capital and socioeconomic inequalities in health: a contribution to understanding the psychosocial pathway of health inequalities

            Introduction Recent research on health inequalities moves beyond illustrating the importance of psychosocial factors for health to a more in-depth study of the specific psychosocial pathways involved. Social capital is a concept that captures both a buffer function of the social environment on health, as well as potential negative effects arising from social inequality and exclusion. This systematic review assesses the current evidence, and identifies gaps in knowledge, on the associations and interactions between social capital and socioeconomic inequalities in health. Methods Through this systematic review we identified studies on the interactions between social capital and socioeconomic inequalities in health published before July 2012. Results The literature search resulted in 618 studies after removal of duplicates, of which 60 studies were eligible for analysis. Self-reported measures of health were most frequently used, together with different bonding, bridging and linking components of social capital. A large majority, 56 studies, confirmed a correlation between social capital and socioeconomic inequalities in health. Twelve studies reported that social capital might buffer negative health effects of low socioeconomic status and five studies concluded that social capital has a stronger positive effect on health for people with a lower socioeconomic status. Conclusions There is evidence for both a buffer effect and a dependency effect of social capital on socioeconomic inequalities in health, although the studies that assess these interactions are limited in number. More evidence is needed, as identified hypotheses have implications for community action and for action on the structural causes of social inequalities.
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              Social context, sexual networks, and racial disparities in rates of sexually transmitted infections.

              Social context (demographic, socioeconomic, macroeconomic, and sociopolitical features of the environment) influences the epidemiology and consequences of individual behaviors that affect health outcomes. This article examines the role of social context in heterosexual networks that facilitate the spread of human immunodeficiency virus (HIV) infection and other sexually transmitted infections (STIs), particularly in relation to persistent racial disparities in rates of STIs in the United States. Review of the medical, public health, and social science literature. Contextual factors, such as poverty, discrimination, epidemiology of illicit drug use in the community, ratio of men to women, incarceration rates, and racial segregation, influence sexual behavior and sexual networks directly and indirectly through a variety of mechanisms. Disparities in these contextual features likely contribute substantially to the persistence of marked racial disparities in rates of STIs. Given the importance of contextual factors and the sharply contrasting social contexts for blacks and whites, exclusive emphasis on individual risk factors and determinants is unlikely to produce solutions that will significantly decrease HIV rates among blacks. Effective HIV prevention in this population will require multidisciplinary research to address the contextual factors that promote patterns of sexual networks that facilitate transmission of STIs.
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                Author and article information

                Contributors
                (617) 384-8814 , yransome@hsph.harvard.edu
                Journal
                AIDS Behav
                AIDS Behav
                AIDS and Behavior
                Springer US (New York )
                1090-7165
                1573-3254
                17 October 2016
                17 October 2016
                2017
                : 21
                : 3
                : 891-904
                Affiliations
                [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
                Article
                1581
                10.1007/s10461-016-1581-9
                5306234
                27752875
                4afdbbcd-4d40-4d1f-80b3-55691a9d67bb
                © The Author(s) 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), 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.

                History
                Funding
                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 :
                Categories
                Original Paper
                Custom metadata
                © Springer Science+Business Media New York 2017

                Infectious disease & Microbiology
                social capital,philadelphia, usa,late hiv diagnosis,neighborhood,hiv care engagement

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