Caregiver perceptions of environment moderate relationship betweenneighborhood characteristics and language skills among youth living withperinatal HIV and uninfected youth exposed to HIV in New York City


Despite the increased recognition of how neighborhood conditions bear on cognitive andacademic outcomes, no studies have examined the influences of objective and subjectiveneighborhood indices on specific areas of cognitive functioning among youth living withperinatal HIV (PHIV). Based on a longitudinal cohort study of psychosocial and behavioral health outcomes in 340 perinatally HIV-exposed but uninfected (PHEU) and PHIV youth residing in New York City, ages 9–16 years at enrollment, we analyzed data from baselineand multiple follow-up (FU) quantitative interviews with youth and their primary caregivers, fromwhen they were at least 13-years-old (approximately 4–6 years post enrollment). Census data (percentage of families in neighborhoodliving below the national poverty rate, median neighborhood household income, andpercentage of residents professionally employed) were not independently associated with PPVTscores at both follow-ups. However, in the logistic regression model, the more caregivers perceived their neighborhood as stressful and subjected to violence, the stronger the relationshipbetween census data indicators of low resource neighborhoods and lower PPVT scores for bothgroups. Findings support“place-based”policies and practices that alleviate caregiver experiencesof neighborhood stressors which may contribute to improved cognitive outcomes for youthliving with and affected by PHIV.

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