Study: Poverty, more than race, tied to HIV
Associated Press | 7/20/2010, 7:41 p.m.
ATLANTA — Poverty is perhaps the most important factor in whether inner-city heterosexuals are infected with the AIDS virus, according to the first government study of its kind.
The study, released Monday, suggests that HIV is an epidemic in certain poverty-stricken urban neighborhoods. And, more significantly, poor heterosexuals in those neighborhoods were twice as likely to be infected as heterosexuals who lived in the same community but had more money.
Federal scientists found that race was not a factor — there were no significant differences between blacks, whites or Hispanics.
Health officials have long believed poverty drives HIV epidemics, but there have been few studies to back that up. Some research actually contradicts that belief: studies in Tanzania, Kenya and some other African countries actually found that wealthy people were more likely to be infected than the poor.
“In the United States, we haven’t had a history of looking in depth at the association between poverty and HIV,” said Dr. Jonathan Mermin, director of HIV/AIDS Prevention for the Centers for Disease Control and Prevention. Mermin oversees the CDC team that did the new study.
More often, studies have focused on the race of HIV patients, their sexual orientation or whether or not they use intravenous drugs.
The CDC report was released at the international AIDS conference in Vienna.
The study involved a survey in 2006 and 2007 of 9,000 heterosexual adults, ages 18 to 50. They answered questions on a computer about their income, condom use and other details and were given HIV tests.
The research was done in high-poverty neighborhoods in 23 U.S. cities. It focused on heterosexuals who don’t use intravenous drugs; that group accounts for about 28 percent of Americans living with HIV. It did not involve gay or bisexual men, who have the highest rates of HIV in the United States.
The results: HIV was detected in 2.4 percent of the people who were living below the federal poverty line, which in 2007 was an annual income of roughly $10,000 or less for an individual. The 2.4 percent translates to roughly 1 in 42 people.
In contrast, infections were found in 1.2 percent of people in the same neighborhoods who made more money than the federal poverty guideline. That’s 1 in 83 people.
Both rates were higher than the national average, which is 0.45 percent, or 1 in 222 people.
The results suggest that people in low-income neighborhoods are more likely to be infected because they live among more people who are infected. Perhaps more people in such neighborhoods have used illegal drugs or had other experiences that put them at higher risk, Mermin said.
“It’s epidemiological bad luck,” he said. He described the situation: “I’m in a community where when I meet a new (sexual) partner, the chance that they would have HIV is much higher than if I were wealthy and living in another geographical area.”
Officials need to start looking at the AIDS epidemic in a different light, said Dr. Carlos del Rio, who chairs global health studies at Emory University’s school of public health.