Poor, Urban Heterosexuals at High Risk of HIV: CDC

Risk up to 20 times greater in metropolitan areas with high rates of AIDS

THURSDAY, Aug. 11 (HealthDay News) -- The HIV infection rate among low-income heterosexuals in 24 American cities with a high prevalence of AIDS is 10 to 20 times greater than in the general U.S. population, a new government report indicates.

Two percent of poor heterosexuals in those cities have HIV, according to the U.S. Centers for Disease Control and Prevention researchers' analysis of National HIV Behavioral Surveillance System data.

"More important than using drugs and prostitution, living below the poverty level, not completing high school, being unemployed, being homeless were significantly associated with increased prevalence of HIV," said one expert, Dr. Bruce Hirsch, an attending physician in infectious diseases at North Shore University Hospital in Manhasset, N.Y.

"Being poor and uneducated is dangerous, tragic and expensive for society," said Hirsch, who was not involved in the study.

HIV is the virus that causes AIDS.

The link between high HIV rates and low socioeconomic status couldn't be attributed to factors typically associated with HIV infection risk in heterosexuals, such as crack cocaine use, being diagnosed with a sexually transmitted disease, or having an exchange sex partner, the investigators noted.

While major racial disparities are a feature of the HIV/AIDS epidemic in the United States, the researchers found no racial/ethnic-related differences in HIV infection rates among low-income heterosexuals in cities.

Based on their findings, the CDC authors recommended that HIV prevention programs aimed at heterosexuals should focus on those in low-income areas.

Another expert wasn't surprised by the findings.

"Epidemiologists knew by 1984 that the then-new disease would ultimately concentrate among the poor," said Philip Alcabes, an epidemiologist and professor at the Hunter College School of Public Health in New York City. He said "the findings do point up the powerful effects of place [on HIV transmission]: community and neighborhood factors, poverty, and other aspects of social environment."

The study is published in the Aug. 12 issue of the Morbidity and Mortality Weekly Report, published by the CDC. Preliminary results from the study were presented in July 2010 at an international AIDS conference in Vienna, Austria.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about HIV/AIDS.

Robert Preidt SOURCES: Bruce Hirsch, M.D., attending physician, infectious diseases, North Shore University Hospital in Manhasset, N.Y.; Philip Alcabes, Ph.D., epidemiologist and professor, program in urban public health, Hunter College School of Health Sciences, New York City; U.S. Centers for Disease Control and Prevention, news release, Aug. 11, 2011

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