Impact of public housing relocations: Are changes in neighborhood conditions related to STIs among relocaters?

Background:Cross-sectional studies have examined relationships between neighborhood characteristics and STIs. Using data from a cohort of African-American adults relocating from US public housing complexes, we will report results of a multilevel longitudinal analysis testing the hypothesis that adults who experienced greater post-relocation improvements in neighborhood conditions had a lower probability of testing positive for an STI.

Methods:Baseline data were collected from 172 public housing residents before relocations occurred; three additional waves of post-relocation data were collected every 6 months thereafter. PCR methods were used to test participants' urine for Chlamydia, Gonorrhea, and Trichomonas. Individual-level characteristics were assessed via survey. Administrative data describe the census tracts where participants lived at each wave (e.g., sex ratios, STI prevalence, poverty rates, violent crime rates, and alcohol outlet density). Multilevel models will be used to test hypotheses.

Results:At baseline, 27.3% of participants tested positive for an STI; at Wave 4, 15.7% of participants tested positive. Tract conditions improved as well. For example, the mean tract-level poverty rate declined from 46% at baseline to 28% at Wave 4, and the violent crime rate dropped from 3.4 to 2.3 per 1000 residents. Results of multilevel analyses testing associations between tract-level changes and STI are pending.

Discussion:Relocaters experienced significant post-relocation declines in STIs and substantial improvements in multiple tract-level conditions. Multilevel analyses will determine whether tract-level improvements were associated declining probability of testing positive for an STI, and will identify which were most important. We will discuss implications for future research, interventions, and housing policies.