Both neighborhood and individual-level social cohesion are associated with testing for HIV in Southeastern Pennsylvania adult population

Purpose

Neighborhood social capital is hypothesized to influence whether people test for infectious diseases. However, it is unknown whether neighborhood and individual social capital simultaneously influence HIV testing.

Methods

We used multivariable multilevel logistic regression to examine whether census tract-level and individual-level social capital (collective engagement and civic and social participation), as well as social cohesion (trust in neighbors, neighbors willing to help, feelings of belongingness), were associated with testing for HIV in the past 12 months. Participants were white, Black/African American, and Hispanic/Latino adults ages 18–49 (N = 1418) who participated in the Southeastern Pennsylvania Household Health Surveys 2010 and 2012. There were 106 census tracts in this sample from Philadelphia, PA.

Results

Forty-three percent of participants had an HIV test within the past 12 months. The mean HIV testing across census tracts in the past 12 months was 44 % (SD = 19 %). Neighborhoods (census tracts) explained 8.9 % of the individual-level variance in testing for HIV (Median Odds Ratio [MOR] = 1.72). Greater individual-level trust in neighbors was associated with lower odds of testing for HIV (adjusted Odds Ratio [aOR]:0.76, 95 % CI = 0.66–0.88). Both individual-level (adjusted Odds Ratio [aOR]:1.18, 95 % CI = 1.02–1.37) and census tract-level (adjusted Odds Ratio [aOR]:1.94, 95 % CI = 1.10–3.40) indicators of belonging were associated with higher odds of testing for HIV.

Conclusion

Neighborhood-level and individual-level social capital components should be integrated into interventions to increase HIV testing.