Measuring socioeconomic inequality in the incidence of AIDS: rural-urban considerations.
Low socioeconomic status (SES) influences the risk of acquiring human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and thus should be considered when analyzing HIV/AIDS surveillance data. Most surveillance systems do not collect individual level SES data but do collect residential ZIP code. We developed SES deprivation indices at the ZIP code tabulation area and assessed their predictive validity for AIDS incidence relative to individual neighborhood-level indicators in Florida using reliability analysis, factor analysis with principal component factorization, and structural equation modeling. For urban areas an index of poverty performed best, although the single factor poverty also performed well. For rural areas no index performed well, but the individual indicators of no access to a car and crowding performed well. In rural areas poverty was not associated with increased AIDS incidence. Users of HIV/AIDS surveillance data should consider urban and rural areas separately when assessing the impact of SES on AIDS incidence.
Department of Epidemiology and Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, USA.
Theophile
T
Niyonsenga
Mary Jo
MJ
Trepka
Spencer
S
Lieb
Lorene M
LM
Maddox
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology*; D019352:Censuses; D018450:Disease Progression; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology*; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D007182:Income; D016015:Logistic Models; D008297:Male; D011159:Population Surveillance; D012423:Rural Health / Q000706:statistics & numerical data*; D012923:Social Class; D014481:United States / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data*