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Socio-economic inequality and HIV in South Africa.
BMC Public Health. 2013 Nov 04; 13:1037.BP

Abstract

BACKGROUND

The linkage between the socio-economic inequality and HIV outcomes was analysed using data from a population-based household survey that employed multistage-stratified sampling. The goal is to help refocus attention on how HIV is linked to inequalities.

METHODS

A socio-economic index (SEI) score, derived using Multiple Correspondence Analysis of measures of ownership of durable assets, was used to generate three SEI groups: Low (poorest), Middle, and Upper (no so poor). Distribution of HIV outcomes (i.e. HIV prevalence, access to HIV/AIDS information, level of stigma towards HIV/AIDS, perceived HIV risk and sexual behaviour) across the SEI groups, and other background characteristics was assessed using weighted data. Univariate and multivariate logistic regression was used to assess the covariates of the HIV outcomes across the socio-economic groups. The study sample include 14,384 adults 15 years and older.

RESULTS

More women (57.5%) than men (42.3%) were found in the poor SEI [P<0.001]. HIV prevalence was highest among the poor (20.8%) followed by those in the middle (15.9%) and those in the upper SEI (4.6%) [P<0.001]. It was also highest among women compared to men (19.7% versus 11.4% respectively) and among black Africans (20.2%) compared to other races [P<0.001]. Individuals in the upper SEI reported higher frequency of HIV testing (59.3%) compared to the low SEI (47.7%) [P< 0.001]. Only 20.5% of those in poor SEI had "good access to HIV/AIDS information" compared to 79.5% in the upper SEI (P<0.001). A higher percentage of the poor had a stigmatizing attitude towards HIV/AIDS (45.6%) compared to those in the upper SEI (34.8%) [P< 0.001]. There was a high personal HIV risk perception among the poor (40.0%) and it declined significantly to 10.9% in the upper SEI.

CONCLUSIONS

Our findings underline the disproportionate burden of HIV disease and HIV fear among the poor and vulnerable in South Africa. The poor are further disadvantaged by lack of access to HIV information and HIV/AIDS services such as testing for HIV infection. There is a compelling urgency for the national HIV/AIDS response to maximizing program focus for the poor particularly women.

Authors+Show Affiliations

Epidemiology and Strategic Information Unit, Human Sciences Research Council, Private Bag X41, Pretoria 0001, Gauteng, South Africa. nwabiri@hsrc.ac.za.No affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

24180366

Citation

Wabiri, Njeri, and Negussie Taffa. "Socio-economic Inequality and HIV in South Africa." BMC Public Health, vol. 13, 2013, p. 1037.
Wabiri N, Taffa N. Socio-economic inequality and HIV in South Africa. BMC Public Health. 2013;13:1037.
Wabiri, N., & Taffa, N. (2013). Socio-economic inequality and HIV in South Africa. BMC Public Health, 13, 1037. https://doi.org/10.1186/1471-2458-13-1037
Wabiri N, Taffa N. Socio-economic Inequality and HIV in South Africa. BMC Public Health. 2013 Nov 4;13:1037. PubMed PMID: 24180366.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Socio-economic inequality and HIV in South Africa. AU - Wabiri,Njeri, AU - Taffa,Negussie, Y1 - 2013/11/04/ PY - 2013/04/23/received PY - 2013/10/30/accepted PY - 2013/11/5/entrez PY - 2013/11/5/pubmed PY - 2014/8/26/medline SP - 1037 EP - 1037 JF - BMC public health JO - BMC Public Health VL - 13 N2 - BACKGROUND: The linkage between the socio-economic inequality and HIV outcomes was analysed using data from a population-based household survey that employed multistage-stratified sampling. The goal is to help refocus attention on how HIV is linked to inequalities. METHODS: A socio-economic index (SEI) score, derived using Multiple Correspondence Analysis of measures of ownership of durable assets, was used to generate three SEI groups: Low (poorest), Middle, and Upper (no so poor). Distribution of HIV outcomes (i.e. HIV prevalence, access to HIV/AIDS information, level of stigma towards HIV/AIDS, perceived HIV risk and sexual behaviour) across the SEI groups, and other background characteristics was assessed using weighted data. Univariate and multivariate logistic regression was used to assess the covariates of the HIV outcomes across the socio-economic groups. The study sample include 14,384 adults 15 years and older. RESULTS: More women (57.5%) than men (42.3%) were found in the poor SEI [P<0.001]. HIV prevalence was highest among the poor (20.8%) followed by those in the middle (15.9%) and those in the upper SEI (4.6%) [P<0.001]. It was also highest among women compared to men (19.7% versus 11.4% respectively) and among black Africans (20.2%) compared to other races [P<0.001]. Individuals in the upper SEI reported higher frequency of HIV testing (59.3%) compared to the low SEI (47.7%) [P< 0.001]. Only 20.5% of those in poor SEI had "good access to HIV/AIDS information" compared to 79.5% in the upper SEI (P<0.001). A higher percentage of the poor had a stigmatizing attitude towards HIV/AIDS (45.6%) compared to those in the upper SEI (34.8%) [P< 0.001]. There was a high personal HIV risk perception among the poor (40.0%) and it declined significantly to 10.9% in the upper SEI. CONCLUSIONS: Our findings underline the disproportionate burden of HIV disease and HIV fear among the poor and vulnerable in South Africa. The poor are further disadvantaged by lack of access to HIV information and HIV/AIDS services such as testing for HIV infection. There is a compelling urgency for the national HIV/AIDS response to maximizing program focus for the poor particularly women. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/24180366/Socio_economic_inequality_and_HIV_in_South_Africa_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-1037 DB - PRIME DP - Unbound Medicine ER -