Socioeconomic status and HIV seroprevalence in Tanzania: a counterintuitive relationship.
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).


CONCLUSIONS
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.
Msisha
Wezi M
WM
Europe and Central Asia Human Development Sector, The World Bank, Washington DC, USA.
Kapiga
Saidi H
SH
Earls
Felton
F
Subramanian
S V
SV
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D015528:HIV Seroprevalence; D015497:HIV-1; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009790:Occupations; D016017:Odds Ratio; D015995:Prevalence; D012306:Risk; D012309:Risk-Taking; D012737:Sex Factors; D012923:Social Class; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult