title: National HIV/AIDS mortality, prevalence, and incidence rates are associated with the Human Development Index.
abstract: BACKGROUND
  HIV/AIDS is a worldwide threat to human health with mortality, prevalence, and incidence rates varying widely. We evaluated the association between the global HIV/AIDS epidemic and national socioeconomic development.
  
  
  METHODS
  We obtained global age-standardized HIV/AIDS mortality, prevalence, and incidence rates from World Health Statistics Report of the World Health Organization. The human development indexes (HDIs) of 141 countries were obtained from a Human Development Report. Countries were divided into 4 groups according to the HDI distribution. We explored the association between HIV/AIDS epidemic and HDI information using Spearman correlation analysis, regression analysis, and the Kruskal-Wallis test.
  
  
  RESULTS
  HIV/AIDS mortality, prevalence, and incidence rates were inversely correlated with national HDI (r = -0.675, -0.519, and -0.398, respectively; P < .001), as well as the 4 indicators of HDI (ie, life expectancy at birth, mean years of schooling, expected years of schooling, and gross national income per capita). Low HDI countries had higher HIV/AIDS mortality, prevalence, and incidence rates than that of medium, high, and very high HDI countries. Quantile regression results indicated that HDI had a greater negative effect on the HIV/AIDS epidemic in countries with more severe HIV/AIDS epidemic.
  
  
  CONCLUSIONS
  Less-developed countries are likely to have more severe HIV/AIDS epidemic. There is a need to pay more attention to HIV/AIDS control in less-developed countries, where lower socioeconomic status might have accelerated the HIV/AIDS epidemic more rapidly.
authors.affiliation: Department of Ophthalmology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Li-Xia
authors.initials: LX
authors.lastname: Lou
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Chao-Hui
authors.initials: CH
authors.lastname: Yu
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China. Electronic address: zlym@zju.edu.cn.
authors.forename: You-Ming
authors.initials: YM
authors.lastname: Li
authors.affiliation: Department of Ophthalmology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China. Electronic address: yejuan@zju.edu.cn.
authors.forename: Juan
authors.initials: J
authors.lastname: Ye
mesh_terms: D019049:Developed Countries; D003906:Developing Countries; D014943:Global Health; D015658:HIV Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D015994:Incidence; D015995:Prevalence; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D016019:Survival Analysis
keywords: Global epidemic; Less-developed countries; Socioeconomic status