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Connecting race and place: A county-level analysis of White, Black, and Hispanic HIV prevalence, poverty, and level of urbanization

Author

Listed:
  • Vaughan, A.S.
  • Rosenberg, E.
  • Shouse, R.L.
  • Sullivan, P.S.

Abstract

Objectives. We evaluated the role of poverty in racial/ethnic disparities in HIV prevalence across levels of urbanization. Methods. Using national HIV surveillance data fromthe year 2009, we constructed negative binomial models, stratified by urbanization,withanoutcomeof race-specific, county-level HIV prevalence rates and covariates of race/ethnicity, poverty, and other publicly available data. We estimated model-based Black-White and Hispanic-White prevalence rate ratios (PRRs) across levels of urbanization and poverty. Results. We observed racial/ethnic disparities for all strata of urbanization across 1111 included counties. Poverty was associated with HIV prevalence only in major metropolitan counties. At the same level of urbanization, Black-White and Hispanic-White PRRs were not statistically different from 1.0 at high poverty rates (Black-White PRR = 1.0, 95% confidence interval [CI] = 0.4, 2.9; Hispanic-White PRR = 0.4, 95% CI = 0.1, 1.6). In nonurban counties, racial/ethnic disparities remained after we controlled for poverty. Conclusions. The association between HIV prevalence and poverty varies by level of urbanization. HIV prevention interventions should be tailored to this understanding. Reducing racial/ethnic disparities will require multifactorial interventions linking social factors with sexual networks and individual risks.

Suggested Citation

  • Vaughan, A.S. & Rosenberg, E. & Shouse, R.L. & Sullivan, P.S., 2014. "Connecting race and place: A county-level analysis of White, Black, and Hispanic HIV prevalence, poverty, and level of urbanization," American Journal of Public Health, American Public Health Association, vol. 104(7), pages 77-84.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2014.301997_5
    DOI: 10.2105/AJPH.2014.301997
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    Cited by:

    1. Nanette D Benbow & David A Aaby & Eli S Rosenberg & C Hendricks Brown, 2020. "County-level factors affecting Latino HIV disparities in the United States," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-23, August.
    2. Bruno Takahashi & Ran Duan & Anthony Van Witsen, 2018. "Hispanics’ Behavioral Intentions Toward Energy Conservation: The Role of Sociodemographic, Informational, and Attitudinal Variables," Social Science Quarterly, Southwestern Social Science Association, vol. 99(1), pages 341-361, March.
    3. Bisola O Ojikutu & Sumeeta Srinivasan & Laura M Bogart & S V Subramanian & Kenneth H Mayer, 2018. "Mass incarceration and the impact of prison release on HIV diagnoses in the US South," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-11, June.

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