May 26, 2006

Poverty fuels HIV among black heterosexuals
(Reuters Health)

Poverty is a key reason why African-American heterosexuals have a far higher rate of infection with HIV, the virus that causes AIDS, than other racial groups, a new study suggests.

Friday, May 26, 2006 (Reuters Health)—Poverty is a key reason why African-American heterosexuals have a far higher rate of infection with HIV, the virus that causes AIDS, than other racial groups, a new study suggests.

Between 1999 and 2002, three-quarters of heterosexually transmitted HIV cases in 29 U.S. states were diagnosed among African Americans. But the reasons for the racial disparity have been "elusive," according to the authors of the new study, led by Dr. Adaora A. Adimora of the University of North Carolina at Chapel Hill.

For their study, published in the Journal of Acquired Immunodeficiency Syndromes, the researchers interviewed 206 black HIV-positive men and women living in North Carolina, as well as 226 HIV-negative adults.

All of the HIV-positive adults had denied any intravenous (IV) drug use, and the men said they'd never had sex with another man.

But the study uncovered some clear differences between the HIV-positive and HIV-negative comparison group that appeared to contribute to the risk of HIV transmission.

Compared with the HIV-negative group, HIV-positive adults had lower incomes, were more likely to have a history of sexually transmitted diseases (STDs) and more often abused crack cocaine or had a sexual partner who abused IV drugs or crack.

An existing STD helps facilitate the transmission of HIV, which may be one reason why STD history was linked to higher HIV risk, according to Adimora's team. People who use crack, they note, may be at risk because they are more likely than a non-drug user to have unprotected sex with an HIV-positive partner.

However, the study also found that more than one-quarter of HIV-positive men and women denied having any of the highest-risk behaviors like drug use or having a partner who abused drugs. These patients mainly differed from HIV-negative adults in that they had less education and lower incomes.

The "common denominator" to most of these HIV risk factors -- from drug use to low educational attainment -- is poverty, Adimora and her colleagues write.

While education about personal risk factors and greater condom use is key to preventing the spread of HIV, the researchers conclude, public policy also needs to address the social and economic disparities that put African Americans at greater risk of infection.

SOURCE: Journal of Acquired Immunodeficiency Syndromes, April 15, 2006.

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