We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Connecting Race and Place: A County-Level Analysis of White, Black, and Hispanic HIV Prevalence, Poverty, and Level of Urbanization.
- Authors
Vaughan, Adam S.; Rosenberg, Eli; Shouse, R. Luke; Sullivan, Patrick S.
- Abstract
Objectives. We evaluated the role of poverty in racial/ethnic disparities in HIV prevalence across levels of urbanization. Methods. Using national HIV surveillance data from the year 2009, we constructed negative binomial models, stratified by urbanization, with an outcome of race-specific, county-level HIV prevalence rates and covariates of race/ethnicity, poverty, and other publicly available data. We estimated model-based Black–White and Hispanic–White prevalence rate ratios (PRRs) across levels of urbanization and poverty. Results. We observed racial/ethnic disparities for all strata of urbanization across 1111 included counties. Poverty was associated with HIV prevalence only in major metropolitan counties. At the same level of urbanization, Black–White and Hispanic–White PRRs were not statistically different from 1.0 at high poverty rates (Black–White PRR = 1.0, 95% confidence interval [CI] = 0.4, 2.9; Hispanic– White PRR = 0.4, 95% CI = 0.1, 1.6). In nonurban counties, racial/ethnic disparities remained after we controlled for poverty. Conclusions. The association between HIV prevalence and poverty varies by level of urbanization. HIV prevention interventions should be tailored to this understanding. Reducing racial/ethnic disparities will require multifactorial interventions linking social factors with sexual networks and individual risks.
- Subjects
UNITED States; BLACK people; COMPARATIVE studies; CONFIDENCE intervals; STATISTICAL correlation; DATABASES; HISPANIC Americans; HIV infections; MEDICAL information storage &; retrieval systems; METROPOLITAN areas; POPULATION geography; POVERTY; RACE; RESEARCH funding; RISK-taking behavior; RURAL conditions; SOCIAL networks; WHITE people; HEALTH equity; DISEASE prevalence; STATISTICAL models; DESCRIPTIVE statistics; ODDS ratio
- Publication
American Journal of Public Health, 2014, Vol 104, Issue 7, pe77
- ISSN
0090-0036
- Publication type
Article
- DOI
10.2105/AJPH.2014.301997