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Socioeconomic status associated with HIV mortality in Uganda

Thursday, 10 April, 2014

Unemployment, a lack of formal education and claiming housing benefit are all indicators linked with HIV and AIDS-related mortality in Uganda. The findings, published ahead of print in JAIDS, are among the first to link vital socioeconomic status (SES) indicators, including wealth index components, with HIV and AIDS mortality in low- and middle-income countries.

The links between SES and health outcomes are well documented, particularly in higher income countries and in relation to non-communicable diseases. However, the authors note that there is “surprisingly little data on associations between SES and mortality in the context of HIV and AIDS, the largest contributor to adult mortality in Africa.” The bulk of the research conducted in low- and middle-income countries relate to SES and transmission risk for HIV.

The researchers evaluated 1,783 people living with HIV and on antiretroviral treatment in an urban setting in Uganda. Mortality and loss to follow-up were marked against key SES indicators, such as education, employment, access to water, number of dependents and a wealth index, which included housing benefits, and house structure. This study found no association between SES indicators and loss to follow-up. However, it found that having no formal education, fewer than 6 dependents, being unemployed and being on housing benefits were significantly associated with HIV and AIDS related mortality.

The authors state that further research is needed to understand the complexities of how poverty and limited assets affect the clinical outcomes of people living with HIV – even when they are on treatment. They remark: “These findings would further the argument for economic and educational interventions to improve HIV outcomes in low- and middle-income countries.”