Place-based predictors of HIV viral suppression and durable suppression among heterosexuals in New York city.

Scant research has explored place-based correlates of achieving and maintaining HIV viral load suppression among heterosexuals living with HIV. We conducted multilevel analyses to examine associations between United Hospital Fund (UHF)-level characteristics and individual-level viral suppression and durable viral suppression among individuals with newly diagnosed HIV in New York City (NYC) who have heterosexual HIV transmission risk. Individual-level independent and dependent variables came from NYC's HIV surveillance registry for individuals diagnosed with HIV in 2009-2013 (N = 3,159; 57% virally suppressed; 36% durably virally suppressed). UHF-level covariates included measures of food distress, demographic composition, neighborhood disadvantage and affluence, healthcare access, alcohol outlet density, residential vacancy, and police stop and frisk rates. We found that living in neighborhoods where a larger percent of residents were food distressed was associated with not maintaining viral suppression. If future research should confirm this is a causal association, community-level interventions targeting food distress may improve the health of people living with HIV and reduce the risk of forward transmission.

Place-Based Predictors of HIV Viral Suppression and Durable Suppression Among Men Who Have Sex With Men in New York City.

We explore relationships between place characteristics and HIV viral suppression among HIV-positive men who have sex with men (MSM) in New York City (NYC). We conducted multilevel analyses to examine associations of United Hospital Fund (UHF)-level characteristics to individual-level suppression and durable suppression among MSM. Individual-level independent and dependent variables came from MSM in NYC's HIV surveillance registry who had been diagnosed in 2009-2013 (N = 7159). UHF-level covariates captured demographic composition, economic disadvantage, healthcare access, social disorder, and police stop and frisk rates. 56.89% of MSM achieved suppression; 35.49% achieved durable suppression. MSM in UHFs where 5-29% of residents were Black had a greater likelihood of suppression (reference: ≥30% Black; adjusted relative risk (ARR) = 1.07, p = 0.04). MSM in UHFs with <30 MSM-headed households/10,000 households had a lower likelihood of achieving durable suppression (reference: ≥60 MSM-headed households/10,000; ARR = 0.82; p = 0.05). Place characteristics may influence viral suppression. Longitudinal research should confirm these associations.

Living under surveillance: Gender, psychological distress, and stop-question-and-frisk policing in New York City.

A growing body of research highlights the collateral consequences of mass incarceration, including stop-and-frisk policing tactics. Living in a neighborhood with aggressive policing may affect one's mental health, especially for men who are the primary targets of police stops. We examine whether there is an association between psychological distress and neighborhood-level aggressive policing (i.e., frisking and use of force by police) and whether that association varies by gender. The 2009-2011 New York City (NYC) Stop, Question, and Frisk Database is aggregated to the neighborhood-level (N = 34) and merged with individual data from the 2012 NYC Community Health Survey (N = 8066) via the United Hospital Fund neighborhood of respondents' residence. Weighted multilevel generalized linear models are used to assess main and gendered associations of neighborhood exposures to aggressive police stops on psychological distress (Kessler-6 items). While the neighborhood stop rate exhibits inconsistent associations with psychological distress, neighborhood-level frisk and use of force proportions are linked to higher levels of non-specific psychological distress among men, but not women. Specifically, men exhibit more non-specific psychological distress and more severe feelings of nervousness, effort, and worthlessness in aggressively surveilled neighborhoods than do women. Male residents are affected by the escalation of stop-and-frisk policing in a neighborhood. Living in a context of aggressive policing is an important risk factor for men's mental health.

Collateral Damage: The Health Effects of Invasive Police Encounters in New York City.

The health effects of police surveillance practices for the community at-large are unknown. Using microlevel health data from the 2009-2012 New York City Community Health Survey (NYC-CHS) nested within mesolevel data from the 2009-2012 NYC Stop, Question, and Frisk (NYC-SQF) dataset, this study evaluates contextual and ethnoracially variant associations between invasive aspects of pedestrian stops and multiple dimensions of poor health. Results reveal that living in neighborhoods where pedestrian stops are more likely to become invasive is associated with worse health. Living in neighborhoods where stops are more likely to result in frisking show the most consistent negative associations. More limited deleterious effects can be attributed to living in neighborhoods where stops are more likely to involve use of force or in neighborhoods with larger ethnoracial disparities in frisking or use of force. However, the health effects of pedestrian stops vary by ethnoracial group in complex ways. For instance, minorities who live in neighborhoods with a wider ethno racial disparity in police behavior have poorer health outcomes in most respects, but blacks have lower odds of diabetes when they live in neighborhoods where they face a higher risk that a stop will involve use of force by police than do whites. The findings suggest that the consequences of the institutionalization of the carceral state are far-reaching.