A better understanding of the social-structural factors that influence HIV vulnerability is crucial to achieve the goal of ending the HIV epidemic by 2030. Given the role of neighborhoods in HIV outcomes, synthesis of findings from such research is key to inform efforts toward HIV eradication. We conducted a systematic review to examine the relationship between neighborhood-level factors (e.g., poverty) and HIV vulnerability (via sexual behaviors and substance use). We searched six electronic databases for studies published from January 1, 2007 through November 30, 2017 (PROSPERO CRD42018084384). We also mapped the studies’ geographic distribution to determine whether they aligned with high HIV prevalence areas and/or the “Ending the HIV Epidemic: A Plan for the United States”. Fifty-five articles met inclusion criteria. Neighborhood disadvantage, whether measured objectively or subjectively, is one of the most robust correlates of HIV vulnerability. Tests of associations more consistently documented a relationship between neighborhood-level factors and drug use than sexual risk behaviors. There was limited geographic distribution of the studies, with a paucity of research in several counties and states where HIV incidence/prevalence is a concern. Neighborhood influences on HIV vulnerability are the consequence of centuries-old laws, policies and practices that maintain racialized inequities (e.g., racial residential segregation, inequitable urban housing policies). We will not eradicate HIV without multi-level, neighborhood-based approaches to undo these injustices. Our findings inform future research, interventions and policies.

更好地了解影响艾滋病毒脆弱性的社会结构因素对于实现到 2030 年结束艾滋病毒流行的目标至关重要。鉴于社区在艾滋病毒结果中的作用，综合此类研究结果对于为根除艾滋病毒工作提供信息至关重要。我们进行了系统回顾，以研究社区层面的因素（例如贫困）和艾滋病毒易感性（通过性行为和药物使用）之间的关系。我们检索了 6 个电子数据库，查找 2007 年 1 月 1 日至 2017 年 11 月 30 日发表的研究 (PROSPERO CRD42018084384)。我们还绘制了这些研究的地理分布图，以确定它们是否与艾滋病毒高流行地区和/或“结束艾滋病毒流行：美国计划”一致。五十五篇文章符合纳入标准。邻里劣势，无论是客观还是主观衡量，都是艾滋病毒易感性最强有力的相关因素之一。与性危险行为相比，关联测试更一致地记录了邻里因素与吸毒之间的关系。研究的地理分布有限，在艾滋病毒发病率/患病率令人担忧的几个县和州的研究很少。社区对艾滋病毒脆弱性的影响是几个世纪以来维持种族不平等的法律、政策和做法（例如种族居住隔离、不公平的城市住房政策）的结果。如果不采取多层次、以社区为基础的方法来消除这些不公正现象，我们就无法根除艾滋病毒。我们的研究结果为未来的研究、干预措施和政策提供了信息。