Abstract
BackgroundThe 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.MethodsA 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.ResultsMore 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.ConclusionsOur 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.
Highlights
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
Over 95% of people in the poor socio-economic index (SEI) group were black Africans while other races formed close to 47% of those belonging to the upper SEI [P < 001
Using a simplified socio-economic index profile, this study was able to underline the disproportionate distribution of HIV disease burden and fear among the poor in South Africa
Summary
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 debate on the link between poverty and HIV infection in sub-Saharan Africa has continued for almost two decades without definite consensus. A large body of literature in the early years of the HIV epidemic indicated that relative wealth was associated with a higher risk of HIV infection [1,2]. One reason behind the debate is rooted in methodological shortcomings to measure income and poverty at the individual and household levels. Population-based Demographic and Health Surveys (DHS), AIDS Impact Surveys (AIS) and other cluster sample surveys use household ownership of items such as radios, refrigerators, phones and the availability of social amenities such as water, electricity and toilets to indicate levels of poverty. It is believed that possession of these assets and amenities inadequately discriminates poor and non-poor households [5,6].Wealth and social status in rural Africa are still expressed in land, cattle and agricultural ownership, despite a more urban lifestyle becoming common in African populations
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
