Abstract
The link between HIV infection and poverty in sub-Saharan Africa (SSA) is rather complex and findings from previous studies
remain inconsistent. While some argue that poverty increases vulnerability, existing empirical evidence largely support the
view that wealthier men and women have higher prevalence of HIV. In this paper, we examine the association between HIV infection
and urban poverty in SSA, paying particular attention to differences in risk factors of HIV infection between the urban poor
and non-poor. The study is based on secondary analysis of data from the Demographic and Health Surveys from 20 countries in
SSA, conducted during 2003-2008. We apply multilevel logistic regression models, allowing the urban poverty risk factor to
vary across countries to establish the extent to which the observed patterns are generalizable across countries in the SSA
region. The results reveal that the urban poor in SSA have significantly higher odds of HIV infection than their urban non-poor counterparts, despite poverty being associated with a significantly lower risk among rural residents. Furthermore, the gender disparity in HIV infection (i.e. the disproportionate higher risk among
women) is amplified among the urban poor. The paper confirms that the public health consequence of urban poverty that has
been well documented in previous studies with respect to maternal and child health outcomes does apply to the risk of HIV
infection. The positive association between household wealth and HIV prevalence observed in previous studies largely reflects
the situation in the rural areas where the majority of the SSA populations reside.
remain inconsistent. While some argue that poverty increases vulnerability, existing empirical evidence largely support the
view that wealthier men and women have higher prevalence of HIV. In this paper, we examine the association between HIV infection
and urban poverty in SSA, paying particular attention to differences in risk factors of HIV infection between the urban poor
and non-poor. The study is based on secondary analysis of data from the Demographic and Health Surveys from 20 countries in
SSA, conducted during 2003-2008. We apply multilevel logistic regression models, allowing the urban poverty risk factor to
vary across countries to establish the extent to which the observed patterns are generalizable across countries in the SSA
region. The results reveal that the urban poor in SSA have significantly higher odds of HIV infection than their urban non-poor counterparts, despite poverty being associated with a significantly lower risk among rural residents. Furthermore, the gender disparity in HIV infection (i.e. the disproportionate higher risk among
women) is amplified among the urban poor. The paper confirms that the public health consequence of urban poverty that has
been well documented in previous studies with respect to maternal and child health outcomes does apply to the risk of HIV
infection. The positive association between household wealth and HIV prevalence observed in previous studies largely reflects
the situation in the rural areas where the majority of the SSA populations reside.
- Content Type Journal Article
- Category Original Paper
- Pages 1-10
- DOI 10.1007/s10461-012-0217-y
- Authors
- Monica A. Magadi, Department of Sociology, School of Social Sciences, City University, Northampton Square, London, EC1V 0HB UK
- Journal AIDS and Behavior
- Online ISSN 1573-3254
- Print ISSN 1090-7165