Different forms of household wealth are associated with opposing risks for HIV infection in East Africa
Different forms of household wealth are associated with opposing risks for HIV infection in East Africa
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DOI：
10.1016/j.worlddev.2018.09.015
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发表时间：
2019-01-01
影响因子：
6.9
通讯作者：
Hruschka, Daniel
中科院分区：
文献类型：
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作者：
Hadley, Craig;Maxfield, Amanda;Hruschka, Daniel
在撒哈拉以南非洲，物质财富与艾滋病毒感染之间的关系一直是相当多辩论的主题，部分原因是许多研究表明，财富与感染呈正相关。另一些人则对这种结果提出批评，认为这些结果所依据的广泛使用的财富指标未能反映东非生计组合的多样性。使用来自肯尼亚、埃塞俄比亚和坦桑尼亚35,799个家庭的人口代表性数据，我们估计了家庭财富沿着两个不同的维度，分别与工资经济和农业经济的成功相关。男性和女性的回归模型显示，财富类型与艾滋病毒感染之间存在一致和相反的关联。控制年龄，教育和城市居住，沿着工资经济维度增加成就与艾滋病毒感染呈正相关（通常显着）。相比之下，在农业经济方面沿着成就的增加往往与艾滋病毒感染呈负相关，而且与艾滋病毒风险的增加从来没有联系。有趣的是，评估危险性行为的变量并不介导任何类型的财富和艾滋病毒感染之间的关系。我们的研究结果表明，未来关于艾滋病毒与财富之间关系的研究需要考虑到东非国家家庭财富的不同层面。我们的研究结果还产生了新的重要问题，即不同形式的财富为什么以及如何驱动艾滋病毒感染。(C)2018由Elsevier Ltd.出版
The relationship between material wealth and HIV infection in sub-Saharan Africa has been the subject of considerable debate in part because many studies show that wealth is positively associated with infection. Others have critiqued such results, suggesting that the widely used indicators of wealth underlying these results fail to capture the diversity of livelihood portfolios in East Africa. Using population representative data from 35,799 households in Kenya, Ethiopia, and Tanzania, we estimate household wealth along two different dimensions, associated respectively with success in wage economies and agricultural economies. Regression models for men and women show consistent and opposing associations between type of wealth and HIV infection. Controlling for age, education, and urban dwelling, increasing achievement along the wage economy dimension is positively (often significantly) associated with HIV infection. In contrast, increasing achievement along the agricultural economy dimension is often negatively associated with HIV infection, and is never associated with increased HIV risk. Interestingly, variables to assess risky sexual behaviors do not mediate the relationship between either type of wealth and HIV infection. Our results suggest that future studies on the relationship between HIV and wealth need to take into account the different dimensions of household wealth found in East African countries. Our results also generate new, important questions about why and how different forms of wealth drive HIV infection. (C) 2018 Published by Elsevier Ltd.