Most STD/HIV prevention interventions focus on individuals, but risks also vary by community. In order to identify possible community-level interventions, we assessed AIDS risk factors on a county level. Cumulative AIDS incidence (per 100,000) by county, for 1981-1989 and 1995-1999 was calculated, excluding counties with fewer than 50 cases reported in either interval. The 20 counties that had the greatest increase in AIDS incidence were compared to the 20 counties with the greatest decrease using the 1990 Census data and the Community Health Status Reports produced by the HRSA. The 20 highest AIDS increases were by 3.9-7.3 fold; decreases were by 0.45-0.82. Compared to the 20 counties with the greatest decreases, the counties with the greatest increases were more likely to be in the south (18 vs 1), had a larger percentage of African Americans (29% vs 7%), a smaller percentage of Hispanics (1% vs 12%), more individuals living in poverty (20% vs 13%), more people at a low literacy rate (28% vs 20%), more births to mothers aged <18 years (8.4% vs 4.1%), more syphilis cases (163 vs 54 per 100,000), and higher infant mortality rates (1,057 vs 618 per 100,000). All 9 death measures (mortality rates per 100,000) on the HRSA reports, including 3 cancers, injuries, and chronic diseases, were higher in counties where AIDS increased the most. Health in general appears to be poorer in counties where AIDS increased the most, suggesting that prevention efforts aimed at improving community health and well-being overall should be considered.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. Identify demographic/social/environmental characteristics reflecting differences and similarities among counties with the greatest increases or decreases in AIDS incidence rates. 2. List nine death measures indicating overall poor health in counties with the greatest increase in AIDS incidence rates. 3. Explore possibilities for HIV/AIDS prevention interventions at the community level.
Keywords: Community Research, Intervention
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.