Gasik Rayna E, Smith Ethan A, Skeen Simone J, Tokarz Stephanie, Clum Gretchen, Felker-Kantor Erica, Theall Katherine P
Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
Department of Psychology, Hunter College, City University of New York, New York, NY, USA.
AIDS Behav. 2025 Jan;29(1):342-355. doi: 10.1007/s10461-024-04527-4. Epub 2024 Oct 28.
Place-based socio-economic and racial inequities contribute to health disparities among people with HIV (PWH). We used geographic ecological momentary assessment (GEMA) methodologies to explore the interplay between psychosocial outcomes in daily diaries and community spatial measures among PWH in New Orleans. PWH (N = 69) were recruited from a clinic-based cohort study. Micro-longitudinal data were collected via smartphone-based daily diaries and geospatial tracking over 14 days. First, correlations were run between diary derived outcomes (e.g., feeling safe in current location, stress), and spatial measures (e.g., violent crime, alcohol outlets, and vacant lots) within a half-mile buffer around each diary point to understand the real time associations between mood and space. Next, we fit multilevel models, controlling for between-person effects, to assess within-person associations between accumulative spatial daily violence exposure (50m, 100m and 200m buffers), and measures of daily mood and coping. Violent crime, alcohol outlets and vacant lots were inversely correlated with feeling safe and positively correlated with perceived ease of obtaining drugs. Vacant lots were positively associated with stress and inversely correlated with positive mood. Within individuals, higher daily accumulated violence exposure was associated with increased rumination at the 50m buffer level, decreased trust in oneself and others at the 100m buffer, and decreased ratio of positive/negative mood at all buffers. Our results emphasize the intricate interplay between mental wellness, coping mechanisms, and spatial measures in PWH. Future research and interventions for PWH should consider how spatial factors may influence PWH in terms of mental health and care engagement.
基于地点的社会经济和种族不平等导致了艾滋病毒感染者（PWH）之间的健康差异。我们使用地理生态瞬时评估（GEMA）方法，探讨新奥尔良市艾滋病毒感染者日常生活日记中的心理社会结果与社区空间指标之间的相互作用。从一项基于诊所的队列研究中招募了69名艾滋病毒感染者。通过基于智能手机的每日日记和14天的地理空间跟踪收集微观纵向数据。首先，对日记得出的结果（例如，在当前位置感到安全、压力）与每个日记点周围半英里缓冲区内的空间指标（例如，暴力犯罪、酒精销售点和空地）之间进行相关性分析，以了解情绪与空间之间的实时关联。接下来，我们拟合多层次模型，控制个体间效应，以评估累积空间每日暴力暴露（50米、100米和200米缓冲区）与每日情绪和应对措施之间的个体内关联。暴力犯罪、酒精销售点和空地与安全感呈负相关，与感知到的获取毒品的难易程度呈正相关。空地与压力呈正相关，与积极情绪呈负相关。在个体内部，更高的每日累积暴力暴露与50米缓冲区水平的沉思增加、100米缓冲区对自己和他人的信任降低以及所有缓冲区的积极/消极情绪比率降低有关。我们的结果强调了艾滋病毒感染者心理健康、应对机制和空间指标之间的复杂相互作用。未来针对艾滋病毒感染者的研究和干预措施应考虑空间因素如何在心理健康和护理参与方面影响艾滋病毒感染者。
