Wednesday, September 29, 2004

HIV and Poverty

The good folks at the Kaiser Family Foundation provide a daily collection of HIV/AIDS-related news summaries, called the "Daily HIV/AIDS Report." In addition, KFF provides daily reports on health policy and reproductive health.

Today's report includes a brief summary of an opinion piece in the Lancet. In the essay, Lynda Fenton talks about the link between HIV and poverty. She suggests that poverty itself is a co-factor in HIV infection, since persons living in poverty often have poor access to health care and often suffer from malnutrition. The ill effects of poverty on health can break down the body's defenses against HIV.

Fenton talks about the cycle of the epidemic, beginning with folks who have greater economic means, who contract and then spread the epidemic because of their ability to travel. However, since greater economic means often correlates with better educational opportunities, at some point these same groups of folks are in a better position to receive information about HIV and its prevention. Poor folks, on the other hand, are in a worse position to receive those messages, and so the epidemic concentrates in that population.

Fenton was talking about the cycles and causes of the global pandemic and thinking in terms of whole countries, and she was careful not to limit her concept of the root causes of the epidemic to poverty alone. However, there is some value in applying her thoughts to the situation in the U.S.

We talk about the changing face of AIDS because the new infections, while still largely occurring in the gay community, are rapidly increasing among women and people of color in this country. There are statistics all over the place that correlate women and people of color with poor access to health care and lower quality education, especially when combined with poor economic circumstances. It is reasonable to ask whether HIV infection in the U.S. correlates in these populations with those circumstances.

Fenton makes two policy recommendations: (1) end poverty, but (2) don't neglect effective prevention efforts while you're ending poverty.

That sounds like a good plan, even in the U.S.

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