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AIDS incidence and income.

D Fife1, C Mode

  • 1AIDS Activities Coordinating Office, Philadelphia Department of Public Health, PA 19107.

Journal of Acquired Immune Deficiency Syndromes
|January 1, 1992
PubMed
Summary

AIDS incidence stabilized in high-income areas while rising in low-income areas, suggesting unequal access to HIV medical care contributes to disparities in Acquired Immunodeficiency Syndrome (AIDS) progression.

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Area of Science:

  • Public Health
  • Epidemiology
  • Socioeconomic Determinants of Health

Background:

  • Annual increases in AIDS incidence have slowed among men who have sex with men but continue among other risk groups.
  • Indirect evidence suggests medical care for Human Immunodeficiency Virus (HIV) disease may delay AIDS onset, but other explanations exist.

Purpose of the Study:

  • To investigate the relationship between socioeconomic status and changes in AIDS incidence.
  • To examine disparities in AIDS diagnosis and survival rates based on income.

Main Methods:

  • Residents of Philadelphia diagnosed with AIDS were categorized by the per capita income of their census tracts.
  • Analysis stratified by race and HIV infection mode to assess the persistence of income-related trends.
  • Examined associations between income, private medical insurance at diagnosis, and median survival time post-diagnosis.

Main Results:

  • AIDS incidence increased steadily in the lowest income tercile, showed smaller increases in the middle tercile after 1987, and remained level in the highest income tercile.
  • The association between income and incidence changes persisted across different racial groups and HIV transmission routes.
  • Higher income was linked to greater access to private medical insurance (59% vs. 24%) and longer median survival (467 days vs. 359 days).

Conclusions:

  • Socioeconomic factors, particularly income, significantly correlate with AIDS incidence trends and survival outcomes.
  • Findings suggest that access to medical care benefits for HIV disease is unevenly distributed, disproportionately benefiting higher-income populations.
  • Addressing socioeconomic disparities is crucial for mitigating the impact of HIV/AIDS and ensuring equitable health outcomes.

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