Socioeconomic Status and Vulnerability to HIV Infection in Uganda: Evidence from Multilevel Modelling of AIDS Indicator Survey Data
Socioeconomic Status and Vulnerability to HIV Infection in Uganda: Evidence from Multilevel Modelling of AIDS Indicator Survey Data
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DOI：
10.1155/2018/7812146
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发表时间：
2018-01-01
影响因子：
1.7
通讯作者：
Magadi, Monica A.
中科院分区：
文献类型：
--
作者：
Igulot, Patrick;Magadi, Monica A.
背景。社会经济地位（SES）与HIV感染之间的关系存在争议。一些证据表明，较高的社会经济地位与艾滋病毒感染呈负相关，而另一些证据则相反。目标。研究乌干达SES与艾滋病毒感染之间的关系，并研究乌干达的SES与艾滋病毒的关系是否因性别、城乡居住地和时间（2004-2005年和2011年）而异。方法。对2004-2005年和2011年进行的乌干达艾滋病毒/艾滋病指标调查的887组中获得的39,766例个案进行了多水平分析。结果。家庭财富与一般人口和农村地区脆弱性的增加有关。与未受教育程度相比，中等或高等教育与普通人群感染艾滋病毒风险降低37%相关。然而，这种影响在城市地区比农村地区更强烈。除个人因素外，未观察到的社区因素也发挥了重要作用，在考虑个人因素后占未解释方差的9%。结论。家庭财富增加了脆弱性，但教育减少了脆弱性。社会环境对艾滋病毒感染易感性的影响独立于个人因素。提高对艾滋病毒/艾滋病的认识，针对富人和受过小学教育的人的性行为，同时提高受教育程度和处理影响易受艾滋病毒感染的环境因素，是减少乌干达艾滋病毒感染的必要战略。
Background. There is controversy on the association between socioeconomic status (SES) and HIV infection. Some evidence claims higher SES is negatively associated with HIV infection while others report the reverse. Objectives. To examine the association between SES and HIV infection in Uganda and to examine whether the SES-HIV relationship varies by gender, rural-urban place of residence, and time (2004-2005 and 2011) in Uganda. Methods. Multilevel analysis was applied to 39,766 individual cases obtained in 887 clusters of Uganda HIV/AIDS Indicators Survey conducted in 2004-2005 and 2011. Results. Household wealth is associated with increased vulnerability in the general population and in rural areas. Compared with no educational attainment, secondary or higher education is associated with reduced vulnerability to the risk of HIV infection by 37% in the general population. However, this effect was stronger in urban than rural areas. Besides individual-level factors, unobserved community factors too play an important role and account for 9% of unexplained variance after individual-level factors are considered. Conclusion. Household wealth increases vulnerability but education reduces it. The social environment influences vulnerability to HIV infection independent of individual-level factors. HIV/AIDS awareness targeting sexual practices of wealthy individuals and those with primary-level educational attainment together with improving educational attainment and addressing contextual factors influencing vulnerability to HIV infection are necessary strategies to reduce HIV infections in Uganda.