FLATOW: You presented new research at the meeting that shows that many low-income, urban areas have HIV epidemics. We don't think of having HIV epidemics in this country.
Dr. FENTON: That's correct. You know, when we think of the national prevalence of HIV in the United States, that's approximately 0.4 or 0.5 percent, still higher than some other Western, industrialized countries, but nowhere near some of the prevalences that we hear about from sub-Saharan Africa or parts of Southeast Asia.
But what this first-of-a-kind CDC study showed was that in 23 cities across the United States, when we looked at high poverty areas, we found that the prevalence of HIV was in excess of one percent. In fact, the prevalence was 2.1 percent in these 23 cities, much higher than what we usually term a generalized epidemic, which is one percent.
FLATOW: Your study just looked at heterosexual infection rates. Why was that?
Dr. FENTON: Because one of the things we wanted to do was to exclude from the analysis other high-risk populations which have historically high prevalence of disease. For example, men who have sex with men and injecting drug users.
So what the study really shows is even when you exclude those high-risk populations from these high-prevalence poverty areas, we're still seeing high prevalences of HIV. And that means that the level of HIV in these jurisdictions are enough, is enough to sustain onward transmission of HIV in the poorest parts of the United States.
And this is the first time we've done such a large and comprehensive study covering the entire U.S. to really demonstrate the impact of poverty, race and HIV risk.
FLATOW: Did the risks cross all ethnic and racial lines, it just depends on the poverty level?
Dr. FENTON: Well, this is another fantastic finding in this study, which was even when you adjusted for poverty in these areas or low socioeconomic status, the relationship between race and HIV risk disappeared.
For example, the prevalence among blacks in these high-poverty areas was 2.1 percent. In Hispanics, it was also 2.1 percent, and in whites, it was 1.7 percent.
Now, these prevalences are unacceptable, but what it does say is that in these poor areas, the strongest determinant of HIV risk is not the individual's racial or ethnic background, but it's the low socioeconomic status which is driving other risk factors for HIV.
Scientists Say A Gel Can Slow HIV Spread : NPR


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