Place Security and Mental Health: Two Sides of the Same Coin Among Young Adults with Perinatally-Acquired HIV and Exposure in New York City.

Stable housing and perceived safety in one's residential neighborhood (place security) may be critical to health and mental health outcomes in populations affected by HIV. This paper examines how perceived neighborhood disorder and houselessness affect the mental health of young adults with perinatally-acquired HIV infection (YAPHIV) or perinatal HIV exposure without infection (YAPHEU) in a New York City-based longitudinal cohort study. Participants were recruited between 2003 and 2008 when participants were between the ages of 9 and 16 and followed into young adulthood. Data for this paper was collected from follow-up interviews when participants were between 18 and 29 years old (151 YAPHIV; 97 YAPHEU). Associations between changes in perceived neighborhood disorder and houselessness and psychiatric disorder were examined, and the potential moderating effects of HIV-serostatus and neurocognitive abilities were considered. Results from linear mixed-effects modeling indicated that increased perceived neighborhood disorder and houselessness predicted meeting psychiatric disorder criteria over time, regardless of neurocognitive functioning. Notably, newly experienced houselessness significantly raised the risk of psychiatric conditions for YAPHEU but not for YAPHIV. These findings emphasize the necessity of integrating place security considerations into mental health and housing support interventions for both YAPHIV and YAPHEU.