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The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress
Published on: July 4, 2013
Neighborhood Violence and Safety: Report from the MACS WIHS Combined Cohort Study
Mardge H Cohen1, Rohan G Rajagopal2, Elizabeth Daubert2
1Department of Medicine, Stroger Hospital of Cook County, Chicago, IL, USA. mardge.cohen@gmail.com.
AIDS and Behavior
|July 16, 2026
Summary
Neighborhood violence and safety concerns significantly impact health outcomes, particularly for people with HIV. Addressing these structural issues is crucial for comprehensive care and improving health.
Area of Science:
- Public Health
- Social Epidemiology
- HIV Research
Background:
- Neighborhood violence and safety concerns are linked to adverse health outcomes, including HIV.
- These factors may also contribute to challenges in maintaining viral suppression among individuals with HIV.
Purpose of the Study:
- To determine the prevalence of neighborhood violence and safety concerns within the MACS WIHS Combined Cohort Study.
- To identify factors associated with perceptions of neighborhood violence and safety concerns.
Main Methods:
- Cross-sectional analytic design using data from the MACS WIHS Combined Cohort Study.
- Multivariable logistic regression analysis to assess associations between demographic, clinical, and psychosocial factors and perceptions of violence/safety.
Main Results:
- A majority of participants perceived their neighborhoods as violent (59%) and unsafe (69%).
- Factors associated with increased odds of perceiving violence and safety concerns included being Black, female, lower income, less education, substance use, higher stress, depressive symptoms, and frailty.
- Specific associations were noted for women missing HIV appointments, marijuana use, frailty, and for men, smoking/substance use and depressive symptoms.
Conclusions:
- Neighborhood violence and safety concerns are prevalent and disproportionately affect vulnerable populations, including people with HIV.
- The intersection of HIV risk factors with neighborhood violence highlights significant structural challenges impacting comprehensive HIV care.
- Further research and interventions are needed to address these social determinants of health in HIV care.
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