克索瑞波的單心宅

此篇文章轉錄自Los Angeles Times（點此連結）；文章主要論述：在過去，美國的愛滋病盛行率研究限制在兩個高危險群，男同志和使用針筒注射的用藥者，但在此篇研究，試圖先將這兩個族群抽出，做出一份「異性戀」的研究，一、無論膚色和種族，低收入的異性戀其得愛滋病陽性的機率比剩餘的族群高於五倍；二、愛滋病盛行率以總體而言，黑人高於白人八倍，拉丁裔高於白人三倍，但一旦落於貧窮線下（即低收入），這些不同種族的得病率差異就消失了（至少在這份研究中）。基於這份研究，提出四點值得思索之處，一、差異可能不見得在於種族，而是在於社經地位，若有高社經地位越有能力免於疾病，尤其在美國社經地位與種族相綁；二、當我們認為自己因社經地位高而可以免於疾病，這又成為迷思，因為社經地位高的背後實質為，有更多能力與自由接受教育、接受到衛教資訊，並不是因為你的薪水與名聲保護了你的身體；三、貧窮與許多現象常常相綁，譬如高犯罪率，但問題核心真的是貧窮嗎？這部份相關研究的盲點又再度顯現，譬如罹患愛滋病使得該病患收入下降至貧窮線下，並非貧窮使得該病患罹患愛滋病，（抑或這是一個雪上加霜的過程，貧者越貧？）；四、畢竟社會制度與社會環境是連動著疾病盛行率的，如果你認同，貧窮是萬惡之源、社會不公義的縮影，低經濟地位是愛滋病的危險因子（Risk Factor），那麼當你願意關注愛滋病議題時，你是否也願意關注社會上貧窮的議題（M型社會正夯？）。

Poverty and HIV are strongly linked, CDC survey finds 

Regardless of race or ethnicity, heterosexuals living in low-income communities are up to five times more likely to be HIV-positive than the rest of the U.S. population.

By Thomas H. Maugh II, Los Angeles Times

July 20, 2010

Heterosexuals living below the poverty line in U.S. cities are five times as likely as the nation's general population to be HIV-positive, regardless of their race or ethnicity, the federal Centers for Disease Control and Prevention said Monday.

Their neighbors in the impoverished communities who live above the poverty line are 2.5 times as likely to be infected, according to the first comprehensive study of groups that aren't involved in risky behaviors.

Because African Americans are 4.5 times as likely as whites to live in poverty and Latinos are four times as likely to do so, the findings could account for many of the ethnic and racial disparities in human immunodeficiency virus infections in this country, said Dr. Paul Denning, a medical epidemiologist at the CDC. Denning was the lead author of the study, which was released in Vienna at the International AIDS Conference.

In the United States, the overall HIV prevalence rate for blacks is eight times that for whites, while that for Latinos is three times that for whites. "That disparity appears to disappear in very-low-income areas, at least in this study," Denning said at a news conference.

The findings, based on studies of more than 9,000 people in 23 U.S. cities, indicate that these areas now have what the United Nations defines as a generalized HIV epidemic. In the past, the United States has been said to suffer from what is known as a concentrated epidemic, confined primarily to two high-risk groups: gay men and injection drug users. Those individuals were excluded from this survey.

The new results indicate that the epidemic is now firmly established in the heterosexual population and will continue there even if it could be controlled in the high-risk groups.

"There is a powerful link between poverty, low socioeconomic status and HIV," said Dr. Kevin Fenton, director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. "In communities with a generalized epidemic, we need to reach everyone in the community with prevention information and interventions.

"We need to address larger environmental issues, such as poverty, homelessness and substance abuse, which are well beyond the traditional scope of HIV intervention. Addressing those is as essential to HIV prevention as providing condoms."

The study found that 2.1% of heterosexuals living in high-poverty urban areas were HIV-positive. That included 2.4% of those living below the poverty line as defined by the Census Bureau, and 1.2% of those living above it. More than half of the households in the survey had annual incomes below $10,000, Denning said.

Overall, the HIV prevalence rate was 2.1% among blacks, 2.1% among Latinos and 1.7% among whites. In the U.S. at large, 0.45% of the population is HIV-positive.

Because the data from all 23 cities were pooled, results for individual cities are not available. In general terms, however, Western cities had lower rates than those in the Northeast and the South.

In the United States, an estimated 1.1 million people are thought to be HIV-positive and an additional 56,000 are infected each year — a number that has remained constant for more than a decade. The new findings suggest that, by focusing prevention efforts on the high-risk groups, the government has been overlooking a crucial population.

About 18,000 Americans die of AIDS each year.