Skip directly to local search Skip directly to A to Z list Skip directly to navigation Skip directly to site content Skip directly to page options
CDC Home

NCHHSTP Newsroom
Your Connection to the Latest HIV/AIDS, Hepatitis, STD and TB News at CDC

Press Release

For immediate release: July 19, 2010
Media Contact On-Site (Vienna): Elizabeth-Ann Chandler, +1.404.918.3532, echandler@cdc.gov
Additional Contact (Atlanta): National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention - News Media Line, +1.404.639.8895, NCHHSTPMediaTeam@cdc.gov


New CDC Analysis Reveals Strong Link Between Poverty and HIV Infection


New Study in Low-Income Heterosexuals in America's Inner Cities Reveals High HIV Rates


VIENNA – The Centers for Disease Control and Prevention today released a first-of-its-kind analysis showing that 2.1 percent of heterosexuals living in high-poverty urban areas in the United States are infected with HIV.  This analysis suggests that many low-income cities across the United States now have generalized HIV epidemics as defined by the United Nations Joint Program on HIV/AIDS (UNAIDS). 

UNAIDS defines a generalized epidemic as one that is firmly established in the general population, with an overall HIV prevalence in the general population of more than 1 percent.  While subpopulations with higher risk (such as men who have sex with men and injection drug users) may still contribute disproportionately to the spread of HIV in these areas, heterosexual transmission is also sufficient to sustain an epidemic independent of those groups.

The analysis also shows that poverty is the single most important demographic factor associated with HIV infection among inner-city heterosexuals.  Contrary to severe racial disparities that characterize the overall U.S. epidemic, researchers found no differences in HIV prevalence by race/ethnicity in this population.  The analysis will be presented at the XVIII International AIDS Conference in Vienna, Austria.

"This study reveals a powerful link between poverty and HIV risk, and a widespread HIV epidemic in America's inner cities," said Kevin Fenton, M.D., Ph.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.  "In this country, HIV clearly strikes the economically disadvantaged in a devastating way."

The analysis, led by Paul Denning, M.D., a medical epidemiologist in CDC's Division of HIV/AIDS Prevention, included more than 9,000 heterosexual adults (aged 18-50) in high-poverty areas of 23 cities who participated in the 2006-2007 heterosexual cycle of the CDC's National HIV Behavioral Surveillance System.  This system monitors HIV risk behaviors, HIV testing patterns, and use of HIV prevention services among U.S. populations at risk. 

High-poverty areas were defined according to the U.S. Census Bureau, and included areas in which at least 20 percent of residents have household incomes below the poverty line.

Nationally, the United States is considered to have a concentrated HIV epidemic, meaning that it is confined mainly to individuals who engage in high-risk behaviors, which in the United States are primarily gay and bisexual men and injection drug users. 

For this analysis, researchers followed UNAIDS criteria for determining a generalized epidemic, and excluded groups at highest risk for becoming HIV infected.  Those groups not included in this analysis were gay and bisexual men – who continue to represent the majority of new HIV infections in the United States – injection drug users, and sex workers and their clients. 

"These findings have significant implications for how we think about HIV prevention.  We can't look at HIV in isolation from the environment in which people live," said Jonathan Mermin, M.D., director of CDC's Division of HIV/AIDS Prevention.  "This analysis points to an urgent need to prioritize HIV prevention efforts in disadvantaged communities.  We are pleased that President Obama's new National HIV/AIDS Strategy reflects this type of approach, in terms of targeting HIV prevention resources to those in greatest need."
 
Prevalence was especially high in those with the lowest socioeconomic status.  Within the low income urban areas included in the study, individuals living below the poverty line were at  greater risk for HIV than those living above it (2.4 percent prevalence vs. 1.2 percent), though prevalence for both groups was far higher than the national average (0.45 percent).  There were no significant differences in HIV prevalence by race or ethnicity in these low income urban areas:  prevalence was 2.1 percent among blacks, 2.1 percent among Hispanics, and 1.7 percent among whites.  By contrast, the U.S. epidemic overall is characterized by severe racial/ethnic disparities:  the HIV prevalence rate for blacks is almost 8 times that of whites, and the HIV prevalence rate among Hispanics is nearly 3 times that of whites.  

The absence of race-based differences in this analysis is likely due to existing high prevalence of HIV in poor urban areas, which – regardless of race or ethnicity – places individuals living in these areas at greater risk for exposure to HIV with each sexual encounter. 

Authors note that other factors associated with poverty also likely contribute to high HIV prevalence in these settings.  Some of these factors include limited health care access, which can reduce utilization of HIV testing and prevention services; substance abuse, which can increase sexual risk behavior; and high rates of incarceration, which can disrupt the stability of relationships.

This analysis provides greater insight into factors that may be driving heterosexual HIV transmission in the United States, which accounts for 31 percent of new infections each year.  This study did not examine HIV prevalence among groups at higher risk for HIV in these areas, including MSM and IDU.  Nationally, MSM account for 53 percent of new infections, IDU account for 12 percent, and those exposed through both MSM and IDU account for 4 percent.

For more information on HIV in the United States, please visit http://www.cdc.gov/hiv, or http://www.cdc.gov/nchhstp/newsroom.

###

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

 
Media Inquiries:
HIV/AIDS, Hepatitis, STDs or TB
  • (404) 639-8895
    M-F 9am-5:30pm (ET)
  • Email

All Other Topics

Public Inquiries:
  • Centers for Disease Control and Prevention
    1600 Clifton Rd
    Atlanta, GA 30333
  • 800-CDC-INFO
    (800-232-4636)
    TTY: (888) 232-6348

  • Contact CDC–INFO

The NCHHSTP Atlas is an interactive tool that provides CDC an effective way to disseminate HIV, Viral Hepatitis, STD and TB data, while allowing users to observe trends and patterns by creating detailed reports, maps, and other graphics. Find out more! http://www.cdc.gov/nchhstp/atlas/


Prevention Through Health Care

CDC 24/7 – Saving Lives. Protecting People. Saving Money Through Prevention. Learn More About How CDC Works For You

USA.gov: The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Road Atlanta, GA 30329-4027, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
A-Z Index
  1. A
  2. B
  3. C
  4. D
  5. E
  6. F
  7. G
  8. H
  9. I
  10. J
  11. K
  12. L
  13. M
  14. N
  15. O
  16. P
  17. Q
  18. R
  19. S
  20. T
  21. U
  22. V
  23. W
  24. X
  25. Y
  26. Z
  27. #