Ben Lopman|James J. Lewis|Constance Nyamukapa|Phyllis Mushati|S.K. Chandiwana|Simon Gregson
HIV incidence and poverty in Manicaland, Zimbabwe: is HIV becoming a disease of the poor?
Imperial College London|London School of Hygiene & Tropical Medicine|Biomedical Research and Training Institute|Imperial College London|Biomedical Research and Training Institute|University of the Witwatersrand|Biomedical Research and Training Institute|Biomedical Research and Training Institute|Imperial College London
background zimbabwe socioeconomic development complicated changeable relationship hiv infection longitudinal data needed disentangle cyclical effects poverty hiv well separate historical patterns contemporary trends infection methods analysed large populationbased cohort eastern zimbabwe wealth index measured baseline basis household asset ownership associations wealth index hiv incidence mortality sexual risk behaviour sexual mixing patterns analysed results largest decreases hiv prevalence top third wealth index distribution tercile men 25 women 21 men hiv incidence significantly lower top wealth index tercile 154 per 1000 personyears compared lowest tercile 274 per 1000 personyears especially among young men mortality rates significantly lower men women higher wealth index men higher wealth index reported sexual partners also likely use condoms betteroff women reported fewer partners less likely engage transactional sex partnership data suggests increasing likewithlike mixing higher wealth groups resulting reduced probability serodiscordant couples conclusion hiv incidence mortality perhaps sexual risk lower higher socioeconomic groups reduced vulnerability infection led relatively well positive trend absence analogous developments vulnerable groups hiv threatens become disease poor