Examining Neighborhood Poverty-based Disparities in HIV/STI Prevalence: An Analysis of Add Health Data


Zullo, Andrew R.; Adams, Joëlla W.; Gantenberg, Jason R.; Marshall, Brandon D. L.; & Howe, Chanelle J. (2019). Examining Neighborhood Poverty-based Disparities in HIV/STI Prevalence: An Analysis of Add Health Data. Annals of Epidemiology.


Purpose To estimate the effect of exposure to neighborhood poverty in adolescence on HIV/STI prevalence in early adulthood. Methods Longitudinal data from three waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were analyzed. The primary exposure was living in a high versus medium/low poverty neighborhood during Wave I. The outcome was having a sexually transmitted infection (STI) or receiving a HIV/STI diagnosis in the past twelve months at Wave III. Covariates included sociodemographic, behavioral, and mental health-related factors. Inverse probability weighted marginal structural models were used to estimate neighborhood poverty-based differences in HIV/STI prevalence. Results 8,232 Add Health participants comprised the analytic sample. Of these, 16% and 84% resided in high- and medium/low-poverty neighborhoods, respectively. Eleven percent currently had an STI or HIV/STI diagnosis within the prior 12 months. Accounting for measured potential sources of confounding and selection bias, the HIV/STI prevalence difference [95% confidence limits] for those who grew up in high versus medium/low-poverty neighborhoods was 0.015 [-0.015, 0.045]. Conclusions Strong evidence for neighborhood poverty-based differences in HIV/STI prevalence was not observed. Researchers should continue to investigate the effect of neighborhood-level socioeconomic position measures and, if warranted, identify etiologically relevant exposure periods. Topics Infectious Disease, Social Epidemiology, Disparities;





Reference Type

Journal Article

Journal Title

Annals of Epidemiology


Zullo, Andrew R.
Adams, Joëlla W.
Gantenberg, Jason R.
Marshall, Brandon D. L.
Howe, Chanelle J.

Year Published






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