People risk of transmitting it (CDC, 2016). Some

walk through cities everyday and poverty is prevelant though out most cities. There
is a descrepency between those whole are financially well off and those who are
considered in poverty. Human immunodeficiency virus (HIV) is one of these
descrepencies, it is a disease that seems to be attracted to those who are in
poverty. HIV tends affect lower socioeconomic classes at a faster rate than
those at a higher socioeconomic class (American Psychological Association APA,
n.d.). The Center for Disease Control and Prevention (CDC) estimates that there
are about 1.2 million people with HIV living in the United States alone and in
addition 50,000 people become diagnosed every year (2016).  In the publication of HIV/AIDS and
Socioeconomic Status, it states that a lower socioeconomic class is linked to riskier
behavior such as not using a condom after substance use or exchaning sex for
money, drugs, or necessities like food and safety (APA, n.d.). Along the terms
of sex, the prevelence of HIV or other STDs is elevated especially if a person’s
selected partner is from the same ethnicity (CDC, 2016). The CDC also continues
with this idea stating that “those who cannot afford the basics in life may end
up in circumstances that increase their risk for HIV infections (2016).

Once diagnosed with HIV, the tolls to get treatment and stay
on treatment are difficult for those who are in a lower socioeconomic class. Depending on whether the person
is in a resource-rich area or resource poor area can determine the difficulties
they may face with HIV. Example of this are in a resource-rich area they may
have difficulty with addiction or depression which would cause the person to
not adhere to their treatment while those in a resource-poor may not be able to
access healthcare or the treatment (APA, n.d.). The medication is used
to lower the virus in the blood and reduces the risk of transmitting it (CDC,
2016). Some people in poverty have a delayed start on treatment compared to
those who are more financially well off, causing their chance of survival to
reduce. This causes the people in poverty a higher risk of mortality which
research has shown can be almost three times greater than the mortality rate of
a patient in a higher socioeconomic class (APA, n.d.).

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A low education rate, along
with other socioeconomic indicators, is associated with a higher mortality rate
(APA, n.d.). Those with a lower education may not have been taught about HIV
prevention. Along with education is language barriers or even concerns about
immigration status causing people to act in ways that they may or may not know
is unsafe spreading this virus to another person (CDC, 2016). HIV is common
among those who have less than a high school education and are unemployed. (CDC,
2016). There has been a great deal of research done on the correlation of
poverty and HIV occurrence since it is so prevalent and such a dangerous virus
if not treated with the appropriate ART treatment. This literature review will
be done in chronological order to show how research is progressing in this

Literature Review

Food Insecurity and Other Poverty Indicators Among People Living with
HIV/AIDS: Effects on Treatment and Health Outcomes

In Food Insecurity and Other Poverty Indicators Among People
Living with HIV/AIDS: Effects on Treatment and Health Outcomes the authors Seth
C. Kalichman, Dominica Hernandez, Chauncey Cherry, Moira O. Kalichman, Christopher
Washington, and Tamar Grebler (2014) determined what indication of poverty such as food insecurity
related to those who are HIV positive and taking ART. Medication absorption
can be interfered with when food absorption is not prevalent causing a possible
increase in risk for disease progression.  This was a quantitative observational study. The
researchers used surveys to conduct the research which questioned a total of 521
people (364 male, 157 female) all of which had to prove that they were HIV
positive in order to participate.

measuring tool was the survey. This survey was the independent variable and the
people participating were the dependent variable. The survey consisted of
questions that assessed demographic, social, and health characteristics, food insecurities,
housing, transportation, HIV treatment access and ART adherence. In addition, each
participant was asked to step on the provided scale to measure their BMI.  Each survey was handed in anonymously.

With different parts of the survey, the researchers
discovered different things. Within demographic characteristics, participants
were asked their gender (male 70%, female 30%), age, years of education (12.3
years), income, ethnicity (92% African American), employment status (98% unemployed),
and the 5-digit postal code in order to determine if some areas are
resource-poor or they there in a food-desert. For the health characteristics,
the researchers asked the participants their most recent HIV RNA viral load and
CD4 count. The HIV viral load was detectable for about 16% of people and the
CD4 being less than 500 was about 50% of participants.

The results showed that there was an association between
food insecurity and poverty markers. By looking at table 1, it shows that the
average education is around high school level (12.3 years) education and 98% of
the people surveyed are unemployed along with being HIV positive.  Although about 88% of people surveyed, only 68%
stated in their survey that they were more than 85% adherent to ART. Lastly, approximately
25% of people reported either skipping or downsizing their meal because of financial
reasons. In the food insecure category in table three, 31% stated that they had
to choose between food and medication. These results show that there has been
times that it is difficult for these people financially and some have even come
to the point of having to decide whether they should pay for food or medication
with what money they have.

The significance of the results show that people are living
with food insecurities are at risk of poor HIV treatment. Food insecurity also
showed relation to not receiving ART and poor adherence to ART.

Strengths of this article include being able to have a
survey that all participants were able to complete to their best ability
without having to change the questions in a way that would change the response.
The researchers were also able to find a decent pool to pick from where all were
HIV positive and most were unemployed (98% average). This showed people living
with HIV under poverty. On the other hand, there were some limitations as well.
This included that the study was still small and cannot represent all HIV
positive people, they also aimed for finding people who were experiencing food
insecurity by offering a food basket give-away which had posted notices at
infectious disease clinics and AIDS-related social services. On top of that,
the section of the survey asking about ART adherence, health status, and food
insecurity were all self-reported which could be subject to social response


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