Kang Ezer, Leu Cheng-Shiun, Snyder Jordan, Robbins Reuben N, Bucek Amelia, Mellins Claude A
a Department of Psychology , Howard University , Washington , DC , USA.
b HIV Center for Clinical and Behavioral Studies , New York State Psychiatric Institute, Columbia University , New York , NY , USA.
AIDS Care. 2019 Jan;31(1):61-68. doi: 10.1080/09540121.2018.1492698. Epub 2018 Jun 27.
Despite the increased recognition of how neighborhood conditions bear on cognitive and academic outcomes, no studies have examined the influences of objective and subjective neighborhood indices on specific areas of cognitive functioning among youth living with perinatal HIV (PHIV). In the United States (US), this is of particular concern as HIV has disproportionately affected African American youth living in economically disadvantaged and racially segregated communities. Thus, based on a longitudinal cohort study of psychosocial and behavioral health outcomes in 340 perinatally HIV-exposed but uninfected (PHEU) and PHIV youth residing in New York City, ages 9-16 years at enrollment, we analyzed data from baseline and multiple follow-up (FU) quantitative interviews with youth and their primary caregivers, from when they were at least 13-years-old (approximately 4-6 years post enrollment). We examined the association between baseline neighborhood indices (2000 US census data and caregiver's perception of neighborhood stressors) and youth receptive language skills (PPVT; Peabody Picture Vocabulary Test) at FU2 and FU3. Census data (percentage of families in neighborhood living below the national poverty rate, median neighborhood household income, and percentage of residents professionally employed) were not independently associated with PPVT scores at both follow-ups. However, in the logistic regression model, the more caregivers perceived their neighborhood as stressful and subjected to violence, the stronger the relationship between census data indicators of low resource neighborhoods and lower PPVT scores for both groups. Findings support "place-based" policies and practices that alleviate caregiver experiences of neighborhood stressors which may contribute to improved cognitive outcomes for youth living with and affected by PHIV.
尽管人们越来越认识到邻里环境对认知和学业成绩的影响，但尚无研究考察客观和主观邻里指数对围产期感染艾滋病毒（PHIV）的青少年特定认知功能领域的影响。在美国，这一问题尤为令人担忧，因为艾滋病毒对居住在经济弱势和种族隔离社区的非裔美国青少年影响尤为严重。因此，基于对340名围产期接触艾滋病毒但未感染（PHEU）以及感染艾滋病毒的青少年（年龄在9 - 16岁之间，入组时居住在纽约市）的心理社会和行为健康结果进行的纵向队列研究，我们分析了青少年及其主要照顾者从至少13岁（大约入组后4 - 6年）起的基线和多次随访（FU）定量访谈数据。我们研究了基线邻里指数（2000年美国人口普查数据以及照顾者对邻里压力源的感知）与随访2（FU2）和随访3（FU3）时青少年接受性语言技能（PPVT；皮博迪图片词汇测验）之间的关联。在两次随访中，人口普查数据（邻里中生活在国家贫困线以下的家庭百分比、邻里家庭收入中位数以及专业就业居民百分比）与PPVT分数均无独立关联。然而，在逻辑回归模型中，照顾者越认为他们的邻里环境充满压力且易遭受暴力，低资源邻里的人口普查数据指标与两组较低的PPVT分数之间的关系就越强。研究结果支持“基于地点”的政策和做法，这些政策和做法可减轻照顾者对邻里压力源的体验，这可能有助于改善感染艾滋病毒以及受艾滋病毒影响的青少年的认知结果。
