{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T05:41:37Z","timestamp":1777959697282,"version":"3.51.4"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Adherence to antiretroviral therapy (ART) is crucial for achieving and maintaining viral suppression in people living with HIV (PLWH). While individual factors affecting HIV viral suppression have been extensively studied, there is less attention on community-level factors, specifically perceived neighborhood disorder. This study aims to assess the relationship between perceived neighborhood disorder and achieving virologic suppression among people living with HIV. One hundred and eighty-eight PLWH 18 years of age and older from two HIV clinics completed a cross-sectional study. We assessed perceptions of neighborhood disorder, ART self-efficacy, social support, alcohol and drug use, depression, HIV stigma, provider-patient relationship, demographics, and length at the zip code. HIV viral loads were obtained from the clinical record. The analysis involved the use of Fisher\u2019s Exact test, Spearman\u2019s Rank test, Wilcoxon rank sum test, and Firth logistic regression. All analyses were conducted using STATA 17. Most participants were male (79%), white (62%), and identified as non-Hispanic (66%). Individuals with no perceived neighborhood disorder had median scores of 10 for integration and perseverance in ART self-efficacy. Those with high perceived disorder displayed decreased scores of 8.4 and 8.3 for integration and perseverance respectively. Both integration and perseverance showed statistically significant negative correlations with perceived neighborhood disorder, (Spearman\u2019s rho -0.2966; p&lt;0.000 and -0.2387; p = 0.0010 respectively). Individuals with virologic suppression (n = 167) reported significantly lower perceived neighborhood disorder scores (median = 0.9 [IQR: 0.2\u20132.0]) compared to those without virologic suppression (n = 10, median = 3.2 [IQR: 2.4\u20134], p = 0.0012). The study highlights a notable correlation between perceived neighborhood disorder, ART adherence self-efficacy, and virologic suppression. This indicates that improving HIV treatment outcomes needs to extend beyond individual-level factors and include strategies to address neighborhood-level conditions. Public health policies and programs should consider the broader social and environmental contexts in which people living with HIV reside.<\/jats:p>","DOI":"10.1371\/journal.pgph.0004060","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T18:38:06Z","timestamp":1734633486000},"page":"e0004060","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Perceived neighborhood disorder and achieving HIV viral suppression among adults living with HIV: A cross-sectional study"],"prefix":"10.1371","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2700-1786","authenticated-orcid":true,"given":"Linda Jepkoech","family":"Kimaru","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ChengCheng","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudha","family":"Nagalingam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priscilla","family":"Magrath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0465-6248","authenticated-orcid":true,"given":"Elizabeth","family":"Connick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kacey","family":"Ernst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Ehiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,12,19]]},"reference":[{"key":"pgph.0004060.ref001","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1056\/NEJMoa1105243","article-title":"Prevention of HIV-1 Infection with Early Antiretroviral Therapy","volume":"365","author":"MS Cohen","year":"2011","journal-title":"N Engl J Med"},{"key":"pgph.0004060.ref002","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1097\/QAI.0b013e3182a5c8d4","article-title":"Lifetime Costs and Quality-Adjusted Life Years Saved From HIV Prevention in the Test and Treat Era","volume":"64","author":"PG Farnham","year":"2013","journal-title":"JAIDS J Acquir Immune Defic Syndr"},{"key":"pgph.0004060.ref003","doi-asserted-by":"crossref","first-page":"e81355","DOI":"10.1371\/journal.pone.0081355","article-title":"Closing the Gap: Increases in Life Expectancy among Treated HIV-Positive Individuals in the United States and Canada","volume":"8","author":"H Samji","year":"2013","journal-title":"PLoS One"},{"key":"pgph.0004060.ref004","author":"UNAIDS.","year":"2023","journal-title":"Global HIV & AIDS statistics\u2014Fact Sheet 2023"},{"key":"pgph.0004060.ref005","first-page":"283","article-title":"Understanding FAST-TRACK: Accelerating Action to End the AIDS Epidemic by 2030","author":"UNAIDS.","year":"2015"},{"key":"pgph.0004060.ref006","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1089\/apc.2013.0345","article-title":"The adolescent and young adult HIV cascade of care in the United States: Exaggerated health disparities","volume":"28","author":"BC Zanoni","year":"2014","journal-title":"AIDS Patient Care STDS"},{"key":"pgph.0004060.ref007","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1089\/apc.2017.0009","article-title":"90-90-90-Plus: Maintaining Adherence to Antiretroviral Therapies","volume":"31","author":"IB Corless","year":"2017","journal-title":"AIDS Patient Care STDS"},{"key":"pgph.0004060.ref008","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.pec.2006.08.006","article-title":"Literacy, self-efficacy, and HIV medication adherence.","volume":"65","author":"MS Wolf","year":"2007","journal-title":"Patient Educ Couns"},{"key":"pgph.0004060.ref009","first-page":"191","article-title":"Self-efficacy: Toward a unifying theory of behavioral change","volume":"84","author":"A. Bandura","year":"1977","journal-title":"chol Rev."},{"key":"pgph.0004060.ref010","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1080\/09540121.2018.1426827","article-title":"Social and structural determinants of HIV treatment and care among black women living with HIV infection: a systematic review: 2005\u20132016","volume":"30","author":"A Geter","year":"2018","journal-title":"AIDS Care"},{"key":"pgph.0004060.ref011","doi-asserted-by":"crossref","first-page":"21166","DOI":"10.7448\/IAS.19.1.21166","article-title":"Barriers and facilitators of interventions for improving antiretroviral therapy adherence: a systematic review of global qualitative evidence","volume":"19","author":"Q Ma","year":"2016","journal-title":"J Int AIDS Soc"},{"key":"pgph.0004060.ref012","doi-asserted-by":"crossref","first-page":"S171","DOI":"10.1086\/313849","article-title":"Factors Affecting Adherence to Antiretroviral Therapy","volume":"30","author":"MA Chesney","year":"2000","journal-title":"Clin Infect Dis"},{"key":"pgph.0004060.ref013","first-page":"465","article-title":"Social and Behavioral Theories.","author":"JF Sallis","year":"2008","journal-title":"In: Health Behavior and Health Education: Theory, Research, and Practice [Internet]"},{"key":"pgph.0004060.ref014","article-title":"Broken Windows: The police and neighborhood safety","author":"James Q. Wilson","year":"1982","journal-title":"The Atlantic Monthly"},{"key":"pgph.0004060.ref015","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.socscimed.2018.11.015","article-title":"Broken (windows) theory: A meta-analysis of the evidence for the pathways from neighborhood disorder to resident health outcomes and behaviors","volume":"228","author":"DT O\u2019Brien","year":"2019","journal-title":"Soc Sci Med"},{"key":"pgph.0004060.ref016","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.ejpal.2015.05.001","article-title":"Assessing neighborhood disorder: Validation of a three-factor observational scale","volume":"7","author":"M Marco","year":"2015","journal-title":"Eur J Psychol Appl to Leg Context"},{"key":"pgph.0004060.ref017","first-page":"76","article-title":"Neighbourhood Disorder and its Influence on Resident \u2018 s Health A Case Study of Azamgarh City Neighbourhood Disorder and its Influence on Resident \u2018 s Health A Case Study of Azamgarh City","volume":"65","author":"S Jamal","year":"2018","journal-title":"Geogr"},{"key":"pgph.0004060.ref018","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1177\/002214650504600204","article-title":"Neighborhood Disorder, Psychophysiological Distress, and Health.","volume":"46","author":"TD Hill","year":"2005","journal-title":"J Health Soc Behav"},{"key":"pgph.0004060.ref019","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/B978-0-12-822060-3.00007-3","article-title":"Place attachment theories: a spatial approach to smart health and healing","author":"S Jorgensen","year":"2021","journal-title":"Artificial Intelligence and Big Data Analytics for Smart Healthcare. 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HIV","volume":"14","author":"E Shacham","year":"2013","journal-title":"Med"},{"key":"pgph.0004060.ref025","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.1007\/s10461-019-02757-5","article-title":"Neighborhood Poverty and Control of HIV, Hypertension, and Diabetes in the Women\u2019s Interagency HIV Study","volume":"24","author":"AB Cope","year":"2020","journal-title":"AIDS Behav"},{"key":"pgph.0004060.ref026","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1089\/aid.2021.0039","article-title":"Factors Associated with Viral Suppression Among Racial\/Ethnic Minority Women in the Miami-Dade County Ryan White Program, 2017","volume":"37","author":"SO Caleb-Adepoju","year":"2021","journal-title":"AIDS Res Hum Retroviruses"},{"key":"pgph.0004060.ref027","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1089\/apc.2016.0197","article-title":"Retention in HIV Care and Viral Suppression: Individual- and Neighborhood-Level Predictors of Racial\/Ethnic Differences, 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but not Neighborhood Crime Rate is Associated with Retention in Care Among HIV-Positive Patients","volume":"22","author":"JP Ridgway","year":"2018","journal-title":"AIDS Behav"},{"key":"pgph.0004060.ref031","doi-asserted-by":"crossref","first-page":"e2024577","DOI":"10.1001\/jamanetworkopen.2020.24577","article-title":"Association of Adverse Neighborhood Exposures With HIV Viral Load in Pregnant Women at Delivery","volume":"3","author":"FM Momplaisir","year":"2020","journal-title":"JAMA Netw open"},{"key":"pgph.0004060.ref032","doi-asserted-by":"crossref","first-page":"2987","DOI":"10.1007\/s10461-017-1810-x","article-title":"Place-Based Predictors of HIV Viral Suppression and Durable Suppression Among Men Who Have Sex With Men in New York City","volume":"21","author":"KA Jefferson","year":"2017","journal-title":"AIDS Behav"},{"key":"pgph.0004060.ref033","doi-asserted-by":"crossref","first-page":"e0002870","DOI":"10.1371\/journal.pgph.0002870","article-title":"Neighborhood characteristics and HIV treatment outcomes: A scoping review.","volume":"4","author":"LJ Kimaru","year":"2024","journal-title":"PLOS Glob public Heal"},{"key":"pgph.0004060.ref034","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1177\/2325957416668033","article-title":"The Relationship of Social Support and Neighborhood Perceptions among Individuals with HIV","volume":"16","author":"E Shacham","year":"2017","journal-title":"J Int Assoc Provid AIDS Care"},{"key":"pgph.0004060.ref035","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014A metadata-driven methodology and workflow process for providing translational research informatics support.","volume":"42","author":"PA Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"pgph.0004060.ref036","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: Building an international community of software platform partners.","volume":"95","author":"PA Harris","year":"2019","journal-title":"J Biomed Inform"},{"key":"pgph.0004060.ref037","author":"World Health Organizatoin (WHO).","year":"2019","journal-title":"HIV Treatment and Care Treat All: Policy Adoption and Implementation Status in Countries"},{"key":"pgph.0004060.ref038","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1177\/019027250406700401","article-title":"Seeing Disorder: Neighborhood Stigma and the Social Construction of \u201cBroken Windows.\u201d","volume":"67","author":"RJ Sampson","year":"2004","journal-title":"Soc Psychol Q"},{"key":"pgph.0004060.ref039","first-page":"412","article-title":"Disorder and Decay: The Concept and Measurement of Perceived Neighborhood Disorder","volume":"34","author":"CE Ross","year":"1999","journal-title":"Urban Aff Rev"},{"key":"pgph.0004060.ref040","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s10865-007-9118-3","article-title":"The Role of Self-Efficacy in HIV Treatment Adherence: Validation of the HIV Treatment Adherence Self-Efficacy Scale (HIV-ASES","volume":"30","author":"MO Johnson","year":"2007","journal-title":"). J Behav Med."},{"key":"pgph.0004060.ref041","unstructured":"Centers for Disease Control and Prevention (CDC). HIV treatment as prevention. Available: https:\/\/www.cdc.gov\/hiv\/risk\/art\/index.html"},{"key":"pgph.0004060.ref042","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s40359-018-0249-9","article-title":"Social support in the general population: standardization of the Oslo social support scale (OSSS-3).","volume":"6","author":"R-D Kocalevent","year":"2018","journal-title":"BMC Psychol"},{"key":"pgph.0004060.ref043","doi-asserted-by":"crossref","first-page":"690","DOI":"10.7326\/M16-0317","article-title":"Performance of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool for Substance Use Screening in Primary Care Patients","volume":"165","author":"J McNeely","year":"2016","journal-title":"Ann Intern Med"},{"key":"pgph.0004060.ref044","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0749-3797(18)30622-6","article-title":"Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale).","volume":"10","author":"EM Andresen","year":"1994","journal-title":"Am J Prev Med"},{"key":"pgph.0004060.ref045","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s12955-017-0691-z","article-title":"Development of a 12-item short version of the HIV stigma scale.","volume":"15","author":"M Reinius","year":"2017","journal-title":"Health Qual Life Outcomes"},{"key":"pgph.0004060.ref046","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.genhosppsych.2003.08.010","article-title":"A patient-doctor relationship questionnaire (PDRQ-9) in primary care: development and psychometric evaluation","volume":"26","author":"CM Van der Feltz-Cornelis","year":"2004","journal-title":"Gen Hosp Psychiatry"},{"key":"pgph.0004060.ref047","first-page":"1","article-title":"Community health and economic prosperity: The problem, the causes, the opportunities, and the solutions- at a glance","author":"U.S. Department of Health and Human Services.","year":"2021"},{"key":"pgph.0004060.ref048","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1177\/1359105319869809","article-title":"Effects of individual and neighborhood socioeconomic status on antiretroviral therapy adherence: The role of adherence self-efficacy","volume":"26","author":"Y Jiang","year":"2021","journal-title":"J Health Psychol"},{"key":"pgph.0004060.ref049","doi-asserted-by":"crossref","first-page":"117","DOI":"10.2307\/1389785","article-title":"Neighborhood Socioeconomic Status and Perceptions of Self-Efficacy.","volume":"43","author":"JD Boardman","year":"2000","journal-title":"Sociol Perspect"},{"key":"pgph.0004060.ref050","doi-asserted-by":"crossref","first-page":"3557","DOI":"10.1007\/s10461-017-1700-2","article-title":"Neighborhood Characteristics Associated with Achievement and Maintenance of HIV Viral Suppression Among Persons Newly Diagnosed with HIV in New York City","volume":"21","author":"EW Wiewel","year":"2017","journal-title":"AIDS Behav"},{"key":"pgph.0004060.ref051","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1007\/s10461-021-03450-2","article-title":"Multilevel Analysis of Individual and Neighborhood Characteristics Associated with Viral Suppression Among Adults with HIV in Rio de Janeiro","volume":"26","author":"L Hovhannisyan","year":"2022","journal-title":"Brazil. AIDS Behav"},{"key":"pgph.0004060.ref052","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1089\/apc.2021.0067","article-title":"Neighborhood Factors Associated with Racial\/Ethnic Disparities in Achieving Sustained HIV Viral Suppression Among Miami-Dade County Ryan White Program Clients","volume":"35","author":"R Dawit","year":"2021","journal-title":"AIDS Patient Care STDS"},{"key":"pgph.0004060.ref053","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s12981-016-0120-0","article-title":"The HIV treatment cascade and care continuum: updates, goals, and recommendations for the future","volume":"13","author":"ES Kay","year":"2016","journal-title":"AIDS Res Ther"},{"key":"pgph.0004060.ref054","doi-asserted-by":"crossref","first-page":"e0230041","DOI":"10.1371\/journal.pone.0230041","article-title":"Unfavorable perceived neighborhood environment associates with less routine healthcare utilization: Data from the Dallas Heart Study.","volume":"15","author":"JN Ceasar","year":"2020","journal-title":"PLoS One"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0004060","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T18:38:19Z","timestamp":1734633499000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0004060"}},"subtitle":[],"editor":[{"given":"Julia","family":"Robinson","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,12,19]]},"references-count":54,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,19]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0004060","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,19]]}}}