HIV prevention strategies should target low-income urban areas

Denning PH. MMWR. 2011;60(31):1045-1049.

Issue: September 2011

Two percent of low-income heterosexual adults across 24 US metropolitan areas with a high prevalence for AIDS are infected with HIV — 10 to 20 times greater than the general population, CDC officials reported. Paul H. Denning, MD, and colleagues said low socioeconomic status is a key factor associated with HIV infection among inner-city heterosexuals.

Denning, of the CDC’s Division of HIV/AIDS Prevention, and colleagues pooled 2006 to 2007 data from the National HIV Behavioral Surveillance System (NHBS) on heterosexual adults aged 18 to 50 years residing in 24 metropolitan areas with high AIDS prevalence (n=14,837).

Compared with high school graduates, those with less than a high school education had a higher prevalence for HIV (1.9% vs. 2.8%). Further, those who were unemployed vs. those who were employed (2.6% vs. 1%), those with annual household incomes at or below the poverty level vs. those with incomes above the poverty level (2.3% vs. 1%) and those who were homeless vs. those who were not homeless (3.1% vs. 1.7%) had a higher prevalence for HIV.

This association, according to the researchers, could not be attributed to common factors associated with HIV risk in heterosexuals (crack cocaine use, exchanging sex for money or drugs, or being diagnosed with an STD).

Paul H. Denning, MD

“The association between HIV prevalence and low socioeconomic status in the NHBS survey suggests that improvements in educational and employment opportunities in low-income communities, along with concomitant reductions in poverty, could reduce new HIV infections,” CDC officials wrote in an accompanying editorial. “Without effective approaches to HIV prevention in low-income communities, new HIV infections will continue among these most vulnerable populations.”

Disclosure: The researchers report no relevant financial disclosures.

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