IJE Advance Access originally published online on September 27, 2008
International Journal of Epidemiology 2008 37(6):1297-1303; doi:10.1093/ije/dyn186
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Socioeconomic status and HIV seroprevalence in Tanzania: a counterintuitive relationship
1 Health Specialist, Europe and Central Asia Human Development Sector, The World Bank, Washington DC, USA.
2 Department of Global Health and Population, Harvard School of Public Health, Boston, MA 02115, USA.
3 Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA 02115, USA.
* Corresponding author. Department of Society, Human Development and Health, Harvard School of Public Health, 677 Huntington Ave, Kresge Building, 7th floor, Boston, MA 02115, USA. E-mail: svsubram{at}hsph.harvard.edu
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Abstract |
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Objective To examine the relationship between multiple dimensions of socioeconomic status (SES) and HIV seroprevalence in Tanzania.
Methods Using a large nationally representative sample of 7515 sexually active adults drawn from the 2003–04 Tanzania HIV/AIDS Indicator Survey, we analysed the relationship between multiple SES measures and HIV seroprevalence using weighted logistic regression models.
Results In adjusted models, individuals in the highest quintile of standard of living had increased odds ratio (OR) of being HIV-positive (male: OR 2.38, 95% CI 1.17–4.82; female: OR 3.74, 95% CI 2.16–6.49). Occupational status was differentially associated with HIV in men and women; women in professional jobs had higher OR of being HIV-positive (OR 1.54, 95% CI 1.02–2.38), whereas unemployed men had higher risk of being HIV-positive (OR 3.49, 95% CI 1.43–8.58). No marked association was found between increasing education and HIV seroprevalence for men (P = 0.83) and women (P = 0.87).
Conclusion Contrary to the prevailing perception that low SES individuals tend to be more vulnerable to HIV-infection, we found a positive association between standard of living and HIV-infection. Strategies aimed at reducing HIV-infection needs to be cognizant of the complex social heterogeneity in the patterns of HIV-infection.
Keywords HIV, seroprevalence, socioeconomic status, standard of living, education, Tanzania
Accepted 12 August 2008
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