Community Characteristics Can Influence Individual Risk for HIV Infection, Study Says
People living in "relatively robust and mobile" communities appear to be at higher risk for HIV infection than people who live in communities without a lot of economic activity and trade, according to a study in the current issue of the journal Sexually Transmitted Infections, Reuters Health reports. To track the impact of community settings on a person's risk of HIV infection, researchers studied surveys conducted in a rural area of Northwest Tanzania that was home to about 20,000 people (Mozes, Reuters Health, 9/25). The scientists looked at the influence of four community factors in subvillages: the level of social and economic activity, the ratio of female bar workers per male population aged 18 to 59, the level of community mobility and distance to the nearest town. All four factors were found to have a "strong" impact on HIV risk. Men who lived in subvillages with the highest level of social and economic activity were five times as likely to be HIV-positive as men in places with low levels of activity. Women who lived in communities with the highest level of social and economic activity were twice as likely to be HIV-positive as women living in places with low social and economic activity (Bloom et al., Sexually Transmitted Infections, August 2002). Men who lived in villages with a larger mobile population or with a higher proportion of female bar workers -- many of whom "formally or informally" exchange sex for money or goods -- were also at higher risk for HIV infection. Although women in these communities were also at higher risk for HIV, their level of risk was lower than that of men. The researchers state that stronger economies may contribute to HIV infection because the local population comes into contact with a larger pool of people, and thus a larger pool of potential sex partners, who may already be HIV-positive. They concluded that although community factors do "not displace" individual risk factors for HIV infection, individual risk and community risk tend to rise and fall in conjunction. Noting that HIV prevention campaigns in Africa have "failed to dramatically increase condom use" or lower risk behavior, the researchers suggest that future prevention efforts focus "as much on the characteristics of high-risk places as they do on the behavior of high-risk people" (Reuters Health, 9/25).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.