The disproportionate high risk of HIV infection among the urban poor in sub-Saharan Africa.
The disproportionate high risk of HIV infection among the urban poor in sub-Saharan Africa.
复制标题
撒哈拉以南非洲城市贫困人口中艾滋病毒感染的高度高风险。
DOI：
10.1007/s10461-012-0217-y
复制
发表时间：
2013-06
影响因子：
4.4
通讯作者：
Magadi MA
中科院分区：
文献类型：
--
作者：
Magadi MA
在撒哈拉以南非洲（SSA），艾滋病毒感染与贫困之间的联系相当复杂，以前的研究结果仍然不一致。虽然有些人认为贫困增加了脆弱性，但现有的经验证据在很大程度上支持这样一种观点，即较富裕的男性和女性感染艾滋病毒的几率更高。在本文中，我们研究了SSA中HIV感染与城市贫困之间的关系，特别关注城市贫困人口与非贫困人口之间HIV感染危险因素的差异。这项研究基于对2003-2008年期间在SSA 20个国家进行的人口与健康调查数据的二次分析。我们采用多水平逻辑回归模型，允许城市贫困风险因素在不同国家之间变化，以确定观察到的模式在SSA地区各国之间的推广程度。结果显示，尽管贫困与农村居民感染艾滋病毒的风险明显较低，但SSA的城市贫困人口感染艾滋病毒的几率明显高于城市非贫困人口。此外，艾滋病毒感染的性别差异（即妇女的风险过高）在城市穷人中进一步扩大。这篇论文证实，以前关于孕产妇和儿童健康结果的研究充分记录的城市贫困的公共卫生后果确实适用于感染艾滋病毒的风险。以前的研究中观察到的家庭财富与艾滋病毒流行率之间的正相关关系在很大程度上反映了大多数SSA人口居住的农村地区的情况。
The link between HIV infection and poverty in sub-Saharan Africa (SSA) is rather complex and findings from previous studies remain inconsistent. While some argue that poverty increases vulnerability, existing empirical evidence largely support the view that wealthier men and women have higher prevalence of HIV. In this paper, we examine the association between HIV infection and urban poverty in SSA, paying particular attention to differences in risk factors of HIV infection between the urban poor and non-poor. The study is based on secondary analysis of data from the Demographic and Health Surveys from 20 countries in SSA, conducted during 2003-2008. We apply multilevel logistic regression models, allowing the urban poverty risk factor to vary across countries to establish the extent to which the observed patterns are generalizable across countries in the SSA region. The results reveal that the urban poor in SSA have significantly higher odds of HIV infection than their urban non-poor counterparts, despite poverty being associated with a significantly lower risk among rural residents. Furthermore, the gender disparity in HIV infection (i.e. the disproportionate higher risk among women) is amplified among the urban poor. The paper confirms that the public health consequence of urban poverty that has been well documented in previous studies with respect to maternal and child health outcomes does apply to the risk of HIV infection. The positive association between household wealth and HIV prevalence observed in previous studies largely reflects the situation in the rural areas where the majority of the SSA populations reside.