A new report from the Centers for Disease Control and Prevention confirms that income and education are greater indicators of HIV risk among inner-city heterosexuals.
The analysis shows that poverty is the single most important demographic factor associated with HIV infection among inner-city heterosexuals, says the CDC. Ultimately, despite severe racial disparities that characterize the overall U.S. epidemic, researchers found no differences in HIV prevalence by race/ethnicity in this population.
"These findings have significant implications for how we think about HIV prevention. We can't look at HIV in isolation from the environment in which people live," said Jonathan Mermin, M.D., director of CDC's Division of HIV/AIDS Prevention.
Writes the CDC:
“Prevalence was especially high in those with the lowest socioeconomic status. Within the low income urban areas included in the study, individuals living below the poverty line were at greater risk for HIV than those living above it (2.4 percent prevalence vs. 1.2 percent), though prevalence for both groups was far higher than the national average (0.45 percent). There were no significant differences in HIV prevalence by race or ethnicity in these low income urban areas: prevalence was 2.1 percent among Blacks, 2.1 percent among Hispanics, and 1.7 percent among whites. By contrast, the U.S. epidemic overall is characterized by severe racial/ethnic disparities: the HIV prevalence rate for Blacks is almost eight times that of whites, and the HIV prevalence rate among Hispanics is nearly three times that of whites.“
The study showed that many low-income cities across the United States now have generalized HIV epidemics due to the percentage of heterosexuals living in high-poverty urban areas infected with HIV. The United Nations Joint Program on HIV/AIDS defines a generalized epidemic as one that is established in the general population, with an overall HIV prevalence in the general population of more than one percent.
The study may offer more insight into factors that may be driving heterosexual HIV transmission in the U.S, which accounts for 31 percent of new infections each year. This study did not examine HIV prevalence among groups at higher risk for HIV in these areas, including MSM and intravenous drug users and men who have sex with men but don’t consider themselves homosexual.
"This analysis points to an urgent need to prioritize HIV prevention efforts in disadvantaged communities,” said Mermin.
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