The 1992 Civil Unrest in Los Angeles resulted in the burning of more than 600 buildings and the closure of 221 alcohol outlets. These events serve as a natural experiment to test the influence of community institutions, [both alcohol outlets and community-based organizations-(CBOs)] on HIV risk in a longitudinal, ecological study. We propose to use longitudinal data of gonorrhea and HIV rates and neighborhood conditions to determine 1) if gonorrhea rates dropped in local neighborhoods where alcohol outlets were closed, 2) if there is an association between changes in neighborhood deterioration (or reconstruction) and changes in rates of gonorrhea, and 3) if there is an association between changes in alcohol outlets, neighborhood deterioration and changes in AIDS case rates at the census tract level. In addition, we propose to conduct a qualitative study of the efforts both prior to and since 1992 of CBOs to prevent the relicensure of alcohol outlets to assist in the interpretation of our quantitative study. Data on gonorrhea and HIV will be obtained from the LA County Department of Health Services. Addresses of destroyed buildings will be obtained from the Arson Section of the LA Fire Department. We have already obtained addresses of alcohol licenses that were surrendered in 1992, as well as existing alcohol licenses on an annual basis. All data will be geocoded to the level of the census tract and will be merged with data from the 1990 and 2000 US Census. Spatio-temporal modeling will be employed to determine whether changes in the community institutions (alcohol outlets) and neighborhood rehabilitation (or deterioration) are associated with GC and HIV rates, after controlling for a number of variables, including age, gender, race, socioeconomic status and preexisting rates of GC and HIV. The findings will inform future HIV prevention interventions and provide guidance to CBOs as to whether control of alcohol outlets and neighborhood development may enhance the prevention of HIV transmission.
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