Peoplewalk through cities everyday and poverty is prevelant though out most cities. Thereis a descrepency between those whole are financially well off and those who areconsidered in poverty. Human immunodeficiency virus (HIV) is one of thesedescrepencies, it is a disease that seems to be attracted to those who are inpoverty.
HIV tends affect lower socioeconomic classes at a faster rate thanthose at a higher socioeconomic class (American Psychological Association APA,n.d.). The Center for Disease Control and Prevention (CDC) estimates that thereare about 1.2 million people with HIV living in the United States alone and inaddition 50,000 people become diagnosed every year (2016).
In the publication of HIV/AIDS andSocioeconomic Status, it states that a lower socioeconomic class is linked to riskierbehavior such as not using a condom after substance use or exchaning sex formoney, drugs, or necessities like food and safety (APA, n.d.). Along the termsof sex, the prevelence of HIV or other STDs is elevated especially if a person’sselected partner is from the same ethnicity (CDC, 2016). The CDC also continueswith this idea stating that “those who cannot afford the basics in life may endup in circumstances that increase their risk for HIV infections (2016). Once diagnosed with HIV, the tolls to get treatment and stayon treatment are difficult for those who are in a lower socioeconomic class. Depending on whether the personis in a resource-rich area or resource poor area can determine the difficultiesthey may face with HIV. Example of this are in a resource-rich area they mayhave difficulty with addiction or depression which would cause the person tonot adhere to their treatment while those in a resource-poor may not be able toaccess healthcare or the treatment (APA, n.
d.). The medication is usedto 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 tothose who are more financially well off, causing their chance of survival toreduce.
This causes the people in poverty a higher risk of mortality whichresearch has shown can be almost three times greater than the mortality rate ofa patient in a higher socioeconomic class (APA, n.d.). A low education rate, alongwith other socioeconomic indicators, is associated with a higher mortality rate(APA, n.
d.). Those with a lower education may not have been taught about HIVprevention. Along with education is language barriers or even concerns aboutimmigration status causing people to act in ways that they may or may not knowis unsafe spreading this virus to another person (CDC, 2016). HIV is commonamong 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 ofpoverty and HIV occurrence since it is so prevalent and such a dangerous virusif not treated with the appropriate ART treatment.
This literature review willbe done in chronological order to show how research is progressing in thisfield.Literature ReviewFood Insecurity and Other Poverty Indicators Among People Living withHIV/AIDS: Effects on Treatment and Health OutcomesIn Food Insecurity and Other Poverty Indicators Among PeopleLiving with HIV/AIDS: Effects on Treatment and Health Outcomes the authors SethC. Kalichman, Dominica Hernandez, Chauncey Cherry, Moira O. Kalichman, ChristopherWashington, and Tamar Grebler (2014) determined what indication of poverty such as food insecurityrelated to those who are HIV positive and taking ART. Medication absorptioncan be interfered with when food absorption is not prevalent causing a possibleincrease in risk for disease progression. This was a quantitative observational study.
Theresearchers used surveys to conduct the research which questioned a total of 521people (364 male, 157 female) all of which had to prove that they were HIVpositive in order to participate. Themeasuring tool was the survey. This survey was the independent variable and thepeople participating were the dependent variable. The survey consisted ofquestions that assessed demographic, social, and health characteristics, food insecurities,housing, transportation, HIV treatment access and ART adherence. In addition, eachparticipant 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 researchersdiscovered different things.
Within demographic characteristics, participantswere asked their gender (male 70%, female 30%), age, years of education (12.3years), income, ethnicity (92% African American), employment status (98% unemployed),and the 5-digit postal code in order to determine if some areas areresource-poor or they there in a food-desert. For the health characteristics,the researchers asked the participants their most recent HIV RNA viral load andCD4 count. The HIV viral load was detectable for about 16% of people and theCD4 being less than 500 was about 50% of participants.
The results showed that there was an association betweenfood insecurity and poverty markers. By looking at table 1, it shows that theaverage education is around high school level (12.3 years) education and 98% ofthe 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, approximately25% of people reported either skipping or downsizing their meal because of financialreasons. In the food insecure category in table three, 31% stated that they hadto choose between food and medication. These results show that there has beentimes that it is difficult for these people financially and some have even cometo the point of having to decide whether they should pay for food or medicationwith what money they have.The significance of the results show that people are livingwith food insecurities are at risk of poor HIV treatment. Food insecurity alsoshowed relation to not receiving ART and poor adherence to ART. Strengths of this article include being able to have asurvey that all participants were able to complete to their best abilitywithout 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 wereHIV positive and most were unemployed (98% average). This showed people livingwith 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 HIVpositive people, they also aimed for finding people who were experiencing foodinsecurity by offering a food basket give-away which had posted notices atinfectious disease clinics and AIDS-related social services. On top of that,the section of the survey asking about ART adherence, health status, and foodinsecurity were all self-reported which could be subject to social responsebiases.