The Geography of Violence,Alcohol Outlets,and Drug Arrests in Boston

Objectives. We examined the relationship between alcohol outlets, drug markets (approximated by arrests for possession and trafficking), and violence in Boston, Massachusetts, in 2006. We analyzed geographic and environmental versus individual factors related to violence and identified areas high in violent crime.Methods. We used data from the Boston Police Department, US Census, and Massachusetts State Alcohol Beverage Control Commission. Spatial modeling was employed at the block group level, and violent crime, alcohol outlets, and drug markets were mapped.Results. Relative to other block groups, block groups in the highest decile of violent crime (n = 55) were found to be poorer (e.g., lower incomes, higher percentages of vacant homes), and they had greater numbers of alcohol outlets and higher drug arrest rates. Alcohol outlets and drug possession and trafficking arrests were predictive of violent crime. Also, spatial effects resulting from neighboring block groups were related to violent crime. Both alcohol outlet density and type were associated with violent crime in a differentiated and complex way.Conclusions. With drug possession and trafficking arrests as a proxy for drug markets, spatial relationships between alcohol outlets and violence were found in addition to typical sociodemographic predictors.Understanding the environmental and social contexts in which violence occurs has been an increasingly important area of research, one that has broad applicability to public policies on violence mitigation far beyond purely research issues. Increased theoretical understanding of the spatial and environmental contexts of violence, such as theories relating alcohol outlets to violence, have gone hand in hand with improvements in spatial techniques and computing power, transforming this area of research. Furthermore, although there have been studies on violence related to types and densities of alcohol outlets,1–5 there has been less research attempting to include measures of drug arrests and to more fully incorporate spatial features such as characteristics of adjacent geographic areas.Locations of alcohol outlets are frequently related to occurrence of violence. The incidence of interpersonal violence appears to increase in and around locations with alcohol outlets, particularly bars and liquor stores.1,3–5 There are several possible mechanisms. First, bars and liquor stores often attract individuals likely to be involved in violent interactions, such as young males (alcohol availability theory).6 Second, these retail alcohol outlets are often located in areas with less guardianship than others (social disorganization theory).1,3,7 Third, these types of outlets provide opportunities for social interactions that may lead to violence (alcohol availability and niche theory).Finally, establishments serving alcohol can foster increased expressions of aggression.6 Empirical studies have shown a correlation between higher rates of violence and increased proximity to bars and liquor stores1,8–10 as well as sales through alcohol outlets.11 Similar arguments have been suggested to support empirically observed cross-sectional relationships between rates of violence and locations of off-premise establishments.9,12Establishment effects, however, may be related to other crime-related aspects of the environments of off-premise outlets, such as illegal drug activity and prostitution.13 Questions remain as to whether effects related to alcohol outlets are due to the outlets themselves or the general characteristics of the areas in which they are located. Recent criminological research on bars and taverns suggests that managers of these establishments create environments that suppress or facilitate violence through business-related choices such as types of activities and entertainment, staff and training, and property characteristics.14Two theoretical concerns have guided much of the empirical work over the past 2 decades. First, alcohol outlets might serve as markers for other population or environmental features that are related to violence. These markers could consist of specific population characteristics related to greater levels of violence (e.g., poverty, female-headed households)10 or place-based characteristics related to lower levels of police enforcement and surveillance (e.g., vacant retail establishments).15 Second, violence and alcohol outlets are part of the continuous spatial fabric of communities, and thus standard statistical analyses of data, which assume independence of observations, are complicated by spatial autocorrelation between observations.16 Spatial models have been applied to help correct for bias or increased sampling variation of effect estimates arising from a lack of spatial independence in modeling violence outcomes.17We examined the relationship between alcohol outlets and violent crime in an analytical framework that treats alcohol outlets as potentially both “producers” of violent behavior and markers or attractors of violence. Our initial assessments of the effects of typical sociodemographic measures demonstrated that there remained effects of alcohol outlet presence not accounted for by these features. Subsequently, to capture more spatial and environmental characteristics and to illustrate the presence of spatial effects that were distinct from the 2 types of effects just mentioned, we assessed how adjacent area characteristics relate to violent crime in the target area. To deal with the different ways in which outlets are posited to be related to violence, we accounted for outlet density and type and whether a violent crime occurred on a weekend or weekday.In addition, we included information on drug arrests for trafficking and possession (as estimators of drug markets) to properly account for the relationship between violence and drug markets when assessing the effects of alcohol outlets. Although Martinez et al.18 found a significant relationship between drug markets and violence when accounting for social disorganization, our analysis is the first, to our knowledge, to also include alcohol outlet type and density.     

Perpetration of intimate partner violence by young adult males: The association with alcohol outlet density and drinking behavior

ObjectiveThis study examined the association between alcohol outlet density and male to female intimate partner violence (IPV).MethodData were analyzed from a national probability sample of males who reported a current heterosexual relationship (N=3194). Multinomial logistic regression was used to examine the likelihood of having perpetrated IPV.ResultsHigh alcohol outlet density was associated with having perpetrated physical only IPV (odds ratio [OR]=2.51; 95% confidence interval [CI]: 1.21–5.20). Outlet density was not associated with greater odds of sexual IPV perpetration.ConclusionsAlcohol outlet density was found to be associated with perpetration of physical IPV. Developing environmental strategies with respect to alcohol outlets could potentially reduce perpetration of male-to-female physical IPV.     

Alcohol outlet density is related to police events and motor vehicle accidents in Manukau City,New Zealand

Objectives: To explore the cross‐sectional association between alcohol outlet density and police events in Manukau City, New Zealand. Methods: Using data for the Census Area Unit (suburb) level, per‐capita measures of alcohol outlet density for January 2009 were calculated for off‐licence outlets, clubs and bars, and restaurants and cafés. Data on police events and motor vehicle accidents were obtained for the period 1 July 2008 to 30 June 2009, and also converted into per capita measures. A spatial seemingly unrelated regression model was developed, which simultaneously assessed the relationship between densities and all nine categories of police events, and motor vehicle accidents, while controlling for relevant covariates. Results: All three outlet density measures were significantly associated with a range of police events, but only off‐licence density was significantly associated with motor vehicle accidents. An additional off‐licence outlet in a given area was associated with 85.4 additional police events and 10.3 additional motor vehicle accidents; an additional club or bar was associated with 34.7 additional police events and 0.5 additional motor vehicle accidents; and an additional restaurant or cafe was associated with 13.2 additional police events and 2.1 additional motor vehicle accidents. Conclusions: The results do not imply causality. However, they are broadly consistent with availability theory, and imply that local alcohol policy should account for the effects of additional outlets when new licences are granted. While the methodological approach described here is easily transferable to investigate the relationships elsewhere, we suggest some areas for improvement of future studies.     

The risk of assaultive violence and alcohol availability in Los Angeles County.

OBJECTIVES. Although there is considerable evidence that alcohol consumption facilitates assaultive violence, the extent to which alcohol outlets in a community influence assaultive violence remains controversial. METHODS. To assess the geographic association between city-specific rates of assaultive violence and alcohol-outlet density, an ecologic analysis of the 74 larger cities in Los Angeles County was conducted for the 1990 reporting year. RESULTS. Sociodemographic factors alone accounted for 70% (R2 = .70) of the variance in the rate of assaultive violence in a multiple regression model. Adding the variable for alcohol-outlet density to the model yielded a significant positive slope. The magnitude of this relation indicates that in a typical Los Angeles County city (50,000 residents, 100 outlets, 570 offenses per year), one outlet was associated with 3.4 additional assaultive violence offenses in 1990. CONCLUSIONS. These findings indicate that higher levels of alcohol-outlet density are geographically associated with higher rates of assaultive violence. This association is independent of measured confounders, including city-level measures of unemployment, ethnic/racial makeup, income, age structure, city size, household size, and female-headed households.     

Close proximity to alcohol outlets is associated with increased serious violent crime in New Zealand

Objective: To examine the association between geographic access to alcohol outlets and serious violent crime in New Zealand. Methods: A national study of alcohol outlet access and serious violent crime used a cross‐sectional ecological analysis. Serious violence offences recorded between 2005 and 2007 were aggregated for 286 police station areas. Using Geographical Information Systems (GIS), 9,320 licensed premises were geocoded and road travel distances to the closest alcohol outlet type/category were calculated for each area. Negative binomial regression models measured the association between the distance to the closest alcohol outlet and the number of serious violent offences in each police station area, controlling for area‐level measures of social deprivation, Māori population, young males 15–29 years and population density. Results: There were significant negative associations between distance (access) to licensed outlets and the incidence of serious violent offences with greater levels of violent offending recorded in areas with close access to any licensed premises compared to those areas with least access (IRR 1.5, 95% CI 1.10–2.03); with on‐licensed premises (IRR 1.6, 95% CI 1.16–2.08); and off‐licensed premises (IRR 1.4, 95% CI 1.05–1.93). Conclusion: Having greater geographic access to alcohol outlets was associated with increased levels of serious violent offending across study areas. Implications: Alcohol availability and access promoted under the current liberalised licensing regime are important contextual determinants of alcohol‐related harm within New Zealand communities.     

Neighborhood Alcohol Outlets and the Association with Violent Crime in One Mid-Atlantic City: The Implications for Zoning Policy

Violent crime such as homicide causes significant excess morbidity and mortality in US urban areas. A health impact assessment (HIA) identified zoning policy related to alcohol outlets as one way to decrease violent crime. The objectives were to determine the relationship between alcohol outlets including off-premise alcohol outlets and violent crime in one urban area to provide local public health evidence to inform a zoning code rewrite. An ecologic analysis of census tracts in Baltimore City was conducted from 2011 to 2012. The data included violent crimes (n = 51,942) from 2006 to 2010, licensed alcohol outlets establishments (n = 1,327) from 2005 to 2006, and data on neighborhood disadvantage, percent minority, percent occupancy, and drug arrests from 2005 to 2009. Negative binomial regression models were used to determine the relationship between the counts of alcohol outlets and violent crimes controlling for other factors. Spatial correlation was assessed and regression inference adjusted accordingly. Each one-unit increase in the number of alcohol outlets was associated with a 2.2 % increase in the count of violent crimes adjusting for neighborhood disadvantage, percent minority, percent occupancy, drug arrests, and spatial dependence (IRR = 1.022, 95 % CI = 1.015, 1.028). Off-premise alcohol outlets were significantly associated with violent crime in the adjusted model (IRR = 1.048, 95 % CI = 1.035, 1.061). Generating Baltimore-specific estimates of the relationship between alcohol outlets and violent crime has been central to supporting the incorporation of alcohol outlet policies in the zoning code rewrite being conducted in Baltimore City.     

Evaluation of alcohol outlet density and its relation with violence

OBJECTIVES: The current study set out to investigate alcohol availability in a densely populated, residential area of suburban S?o Paulo associated with high levels of social deprivation and violence. Gun-related deaths and a heavy concentration of alcohol outlets are notable features of the area surveyed. Given the strong evidence for a link between alcohol availability and a number of alcohol-related problems, including violent crime, measures designed to reduce accessibility have become a favored choice for alcohol prevention programs in recent years. METHODS: The interviewers were 24 residents of the area who were trained for the study. It was selected an area of nineteen streets, covering a total distance of 3.7 km. A profile of each alcohol outlet available on the area was recorded. RESULTS: One hundred and seven alcohol outlets were recorded. The number of other properties in the same area was counted at 1,202. Two measures of outlet density may thus be calculated: the number of outlets per kilometer of roadway (29 outlets/km); and the proportion of all properties that sold alcohol (1 in 12). CONCLUSIONS: The results of this study is compared with others which are mainly from developed countries and shown that the area studied have the highest density of alcohol outlet density ever recorded in the medical literature. The implication of this data related to the violence of the region is discussed. By generating a profile of alcohol sales and selling points, it was hoped to gain a better understanding of alcohol access issues within the sample area. Future alcohol prevention policy would be well served by such knowledge.     

The marketing of alcohol to college students: the role of low prices and special promotions

BACKGROUND: Heavy episodic or binge drinking has been recognized as a major problem on American college campuses affecting the health, safety, and education of students. The present study examines the alcohol environment surrounding college campuses and assesses the impact on students' drinking. This environment includes alcohol promotions, price specials, and advertising at drinking establishments that serve beer for on-premise consumption as well as retail outlets that sell beer for off-premise consumption. METHODS: The study used student self-report data from the 2001 College Alcohol Study (CAS) and direct observational assessments by trained observers who visited alcohol establishments in communities where the participating colleges were located. The analytic sample included more than 10,000 students as well as 830 on-premise and 1684 off-premise establishments at 118 colleges. RESULTS: Alcohol specials, promotions, and advertisements were prevalent in the alcohol outlets around college campuses. Almost three quarters of on-premise establishments offered specials on weekends, and almost one half of the on-premise establishments and more than 60% of off-premise establishments provided at least one type of beer promotion. The availability of large volumes of alcohol (24- and 30-can cases of beer, kegs, party balls), low sale prices, and frequent promotions and advertisements at both on- and off-premise establishments were associated with higher binge drinking rates on the college campuses. In addition, an overall measure of on- and off-premise establishments was positively associated with the total number of drinks consumed. CONCLUSIONS: The regulation of marketing practices such as sale prices, promotions, and advertisements may be important strategies to reduce binge drinking and its accompanying problems.     

Social capital and the neighborhood alcohol environment

We examine whether neighborhood alcohol outlet density is associated with reduced social capital and whether this relationship is mediated by perceived neighborhood safety. Hierarchical models from a random sample of Los Angeles, CA, and Louisiana residents (N=2,881) from 217 census tracts were utilized. Substantial proportions of the variance in collective efficacy (intraclass correlation coefficient, ICC=16.3%) and organizational participation (ICC=13.8%, median odds ratio=1.99) were attributable to differences between neighborhoods-suggesting that these factors may be influenced by neighborhood-level characteristics. Neighborhood alcohol outlet density was strongly associated with reduced indicators of social capital, and the relationship between collective efficacy and outlet density appears to be mediated by perceived neighborhood safety. Findings support the concept that off-premise alcohol outlets in the neighborhood environment may hinder the development of social capital, possibly through decreased positive social network expansion.     

Close proximity to alcohol outlets is associated with increased crime and hazardous drinking: Pooled nationally representative data from New Zealand

This nationwide study investigated the relationship between proximity to alcohol outlets (off-licence, on-licence, and other-licence) and two adverse outcomes; hazardous drinking and crime (common assault, non-aggravated sexual assault, aggravated sexual assault, and tobacco and liquor offences). After adjustment for important individual- and area-level factors, close proximity to alcohol outlets was associated with increased risk of hazardous drinking, with strong associations for on-licence outlets. Proximity alcohol outlets was also strongly associated with all crime outcomes, often with a dose-response relationship. Nationally representative New Zealand data showed that close proximity to alcohol outlets was associated with increased crime and hazardous drinking.     

Risk of assaultive violence and alcohol availability in New Jersey.

OBJECTIVES: This study examined the relationship between rate of assaultive violence and density of alcohol outlets in New Jersey. METHODS: Data pertaining to assaultive violence, alcohol outlet density, and sociodemographic factors were obtained from municipalities in New Jersey (n = 223) and assessed through bivariate and multivariate analyses. RESULTS: Sociodemographic factors accounted for 70% (R(2)=.70) of the variance in the rate of assaultive violence. Outlet density did not add significantly to the explained variance of this model. CONCLUSIONS: In New Jersey, alcohol outlet density is not geographically associated with higher rates of violence. Alternative methodological and analytic techniques are required to better specify the relationship between alcohol availability and violence.     

Adverse health conditions and health risk behaviors associated with intimate partner violence--United States, 2005

Intimate partner violence (IPV) is defined as threatened, attempted, or completed physical or sexual violence or emotional abuse by a current or former intimate partner. IPV can be committed by a spouse, an ex-spouse, a current or former boyfriend or girlfriend, or a dating partner. Each year, IPV results in an estimated 1,200 deaths and 2 million injuries among women and nearly 600,000 injuries among men. In addition to the risk for death and injury, IPV has been associated with certain adverse health conditions and health risk behaviors. To gather additional information regarding the prevalence of IPV and to assess the association between IPV and selected adverse health conditions and health risk behaviors, CDC included IPV-related questions in an optional module of the 2005 Behavioral Risk Factor Surveillance System (BRFSS) survey. This report describes the results of that survey, which indicated that persons who report having experienced IPV during their lifetimes also are more likely to report current adverse health conditions and health risk behaviors. Although a causal link between IPV and adverse health conditions cannot be inferred from these results, they underscore the need for IPV assessment in health-care settings. In addition, the results indicate a need for secondary intervention strategies to address the health-related needs of IPV victims and reduce their risk for subsequent adverse health conditions and health risk behaviors.     

Pregnancy, Alcohol Intake, and Intimate Partner Violence among Men and Women Attending Drinking Establishments in a Cape Town, South Africa Township

The highest rates of fetal alcohol syndrome worldwide can be found in South Africa. Particularly in impoverished townships in the Western Cape, pregnant women live in environments where alcohol intake during pregnancy has become normalized and interpersonal violence (IPV) is reported at high rates. For the current study we sought to examine how pregnancy, for both men and women, is related to alcohol use behaviors and IPV. We surveyed 2,120 men and women attending drinking establishments in a township located in the Western Cape of South Africa. Among women 13.3% reported being pregnant, and among men 12.0% reported their partner pregnant. For pregnant women, 61% reported attending the bar that evening to drink alcohol and 26% reported both alcohol use and currently experiencing IPV. Daily or almost daily binge drinking was reported twice as often among pregnant women than non-pregnant women (8.4% vs. 4.2%). Men with pregnant partners reported the highest rates of hitting sex partners, forcing a partner to have sex, and being forced to have sex. High rates of alcohol frequency, consumption, binge drinking, consumption and binge drinking were reported across the entire sample. In general, experiencing and perpetrating IPV were associated with alcohol use among all participants except for men with pregnant partners. Alcohol use among pregnant women attending shebeens is alarmingly high. Moreover, alcohol use appears to be an important factor in understanding the relationship between IPV and pregnancy. Intensive, targeted, and effective interventions for both men and women are urgently needed to address high rates of drinking alcohol among pregnant women who attend drinking establishments.     

Neighbourhood deprivation and alcohol consumption: does the availability of alcohol play a role?

BACKGROUND: Previous studies suggest that the physical availability of alcohol may mediate the association between neighbourhood-level material deprivation and alcohol consumption. This study tests the relationships between neighbourhood-level deprivation, alcohol availability, and individual-level alcohol consumption using a multilevel analysis. METHODS: Data are from cross-sectional surveys conducted between 1979 and 1990 as part of the Stanford Heart Disease Prevention Program (SHDPP). Women and men (n = 8197) living in four northern/central California cities and 82 neighbourhoods were linked to neighbourhood deprivation variables derived from the US census (e.g. unemployment, crowded housing) and to measures of alcohol availability (density of outlets in the respondent's neighbourhood, nearest distance to an outlet from the respondent's home, and number of outlets within a half mile radius of the respondent's home). Separate analyses were conducted for on- and off-sale outlets. RESULTS: The most deprived neighbourhoods had substantially higher levels of alcohol outlet density than the least deprived neighbourhoods (45.5% vs 14.8%, respectively). However, multilevel analyses showed that the least deprived neighbourhoods were associated with the heaviest alcohol consumption, even after adjusting for individual-level sociodemographic characteristics (OR 1.30, CI 1.08-1.56). Alcohol availability was not associated with heavy drinking and thus did not mediate the relationship between neighbourhood deprivation and heavy alcohol consumption. CONCLUSIONS: Although alcohol availability is concentrated in the most deprived neighbourhoods, women and men in least deprived neighbourhoods are most likely to be heavy drinkers. This mismatch between supply and demand may cause people in the most deprived neighbourhoods to disproportionately suffer the negative health consequences of living near alcohol outlets.     

Urban Young Women’s Experiences of Discrimination and Community Violence and Intimate Partner Violence

This paper examines the interrelationships between urban young adult women’s experiences of discrimination and community violence and their reports of involvement in intimate partner violence (IPV). We explore whether such experiences are independent risk factors for IPV victimization and perpetration, even when accounting for aggressive behaviors and related risk taking, including drinking and sexual initiation, during early adolescence. We use data from the Reach for Health study, in which a sample of 550 urban African American and Latina women was followed from recruitment in economically distressed middle schools into young adulthood, over approximately 7 years. At the last wave, respondents were 19–20 years old; 28% were raising children. More than 40% reported experiencing at least one form of racial/ethnic discrimination sometimes or often over the past year. About 75% heard guns being shot, saw someone being arrested, or witnessed drug deals within this time period; 66% had seen someone beaten up, 26% had seen someone get killed, and 40% knew someone who was killed. Concurrent reports of lifetime IPV were also high: about a third reported being a victim of physical violence; a similar proportion reported perpetration. Results of multivariate regression analyses indicate that discrimination is significantly associated with physical and emotional IPV victimization and perpetration, controlling for socio-demographic characteristics, including ethnic identity formation, and early adolescent risk behaviors. Community violence is correlated with victimization, but the relationship remains significant only for emotional IPV victimization once early behaviors are controlled. Implications for violence prevention are discussed, including the importance of addressing community health, as well as individual patterns of behavior, associated with multiple forms of violence victimization and perpetration. Stueve is with the Health and Human Development Center, 96 Morton Street, 7th Floor, New York, 10014, New York NY, USA. O`Donnell is with the Health and Human Development, Education Development Center, Newton, MA, USA.     

Intimate partner violence in Madrid: a time series analysis (2008–2016)

Purpose

This study analyzes whether there are time patterns in different intimate partner violence (IPV) indicators and aims to obtain models that can predict the behavior of these time series.

Neighborhood Typologies Associated with Alcohol Use among Adults in Their 30s: a Finite Mixture Modeling Approach

There has been increasing interest in how neighborhood context may be associated with alcohol use. This study uses finite mixture modeling to empirically identify distinct neighborhood subtypes according to patterns of clustering of multiple neighborhood characteristics and examine whether these subtypes are associated with alcohol use. Neighborhoods were 303 census block groups in the greater Seattle, WA, area where 531 adults participating in an ongoing longitudinal study were residing in 2008. Neighborhood characteristics used to identify neighborhood subtypes included concentration of poverty, racial composition, neighborhood disorganization, and availability of on-premise alcohol outlets and off-premise hard liquor stores. Finite mixture models were used to identify latent neighborhood subtypes, and regression models with cluster robust standard errors examined associations between neighborhood subtypes and individual-level typical weekly drinking and number of past-year binge drinking episodes. Five neighborhood subtypes were identified. These subtypes could be primarily characterized as (1) high socioeconomic disadvantage, (2) moderate disadvantage, (3) low disadvantage, (4) low poverty and high disorganization, and (5) high alcohol availability. Adjusted for covariates, adults living in neighborhoods characterized by high disadvantage reported the highest levels of typical drinking and binge drinking compared to those from other neighborhood subtypes. Neighborhood subtypes derived from finite mixture models may represent meaningful categories that can help identify residential areas at elevated risk for alcohol misuse.     

The social gradient of alcohol availability in Victoria, Australia

Objectives: To explore the socioeconomic gradient of alcohol availability in Victoria, Australia. Methods: Using data for the smallest geographic units available, per‐capita and area‐based measures of alcohol outlet density were calculated for four types of alcohol outlet (broadly: restaurants, hotels, packaged liquor outlets and licensed clubs). These densities were aggregated across deciles of socioeconomic disadvantage, to compare the average density of alcohol outlets across ten levels of socioeconomic status. In addition, negative binomial regression models were developed, assessing the relationship between density and socioeconomic status while controlling for relevant covariates. Results: In urban areas, both takeaway liquor outlets and licensed clubs were significantly more likely to be located in areas of socioeconomic disadvantage, while hotel and restaurant licences were more prevalent in advantaged areas. In rural and regional Victoria, all types of outlet types were more prevalent in areas of socioeconomic disadvantage. Conclusions: The findings suggest that disparities in exposure to alcohol outlets in Victoria may play a role in explaining socioeconomic disparities in health outcomes, with Victorians living in disadvantaged areas generally faced with higher levels of alcohol availability.     

Unwanted pregnancy,pregnancy loss,and other risk factors for intimate partner violence in the Democratic Republic of the Congo

The Democratic Republic of the Congo (DRC) has one of the highest rates of violence against women in the world; however, few studies have focused on this issue. In this study, we assessed the interrelationship among intimate partner violence (IPV), unintended pregnancy, pregnancy loss, and other sociodemographic factors in the DRC. Our analyses were based on data from the DRC demographic and health survey, conducted from November 2013 to February 2014. We constructed generalized estimating equation models to analyze the data from a sample of 5,120 married women. Our results showed that having a husband or partner who exhibited controlling behaviors, women who justified wife-beating, having a mother who had experienced IPV, and having a husband or partner who consumed alcohol were positively associated with IPV, whereas decision-making autonomy among women was negatively associated with IPV. In the community, the proportion of women who had experienced IPV and that of those who had completed secondary or higher education were positively and negatively associated with any IPV type, respectively. In addition, emotional IPV and any IPV type were positively associated with pregnancy loss. Our results indicate the necessity of implementing programs targeting gender equality at both individual and community levels.     

Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities

The majority of the world's HIV infections occur in communities ravished by poverty. Although HIV/AIDS and poverty are inextricably linked, there are few studies of how poverty-related stressors contribute to HIV risk behavior practices. In this study, surveys were conducted in three South African communities that varied by race and socio-economic conditions: people living in an impoverished African township (N = 499); an economically impoverished but well infrastructured racially integrating township (N = 995); and urban non-impoverished neighborhoods (N = 678). Results showed that HIV/AIDS risks were closely related to experiences of poor education, unemployment, discrimination, violence, and crime. Although poverty-related stressors were associated with a history of alcohol and drug use, substance use did not moderate the association between poverty-related stressors and HIV risk behaviors. The findings suggest that HIV prevention strategies should not treat AIDS as a singled out social problem independent of other social ills.