Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=176572
Story Retrieval Date: 5/24/2013 7:10:57 AM CST

Alison W. Bullock/MEDILL
Heterosexual HIV transmission is linked to areas of poverty in Chicago. Heterosexual HIV transmission made up 23 percent of all transmissions in Chicago in 2008.
Heterosexuals living in Lincoln Park are at lower risk of HIV infection than those living in Englewood, according to information released by the Chicago Department of Public Health Wednesday.
Nik Prachand, a senior epidemiologist in the department’s the STI/HIV/AIDS division , said that people living in neighborhoods where more than 20 percent of households fall below the poverty line are at a higher risk for heterosexual HIV transmissions than those in areas where less than 20 percent are in poverty.
Nearly one-third of all new HIV diagnoses result from heterosexual contact, and 28 percent of people living with HIV were infected through heterosexual contact, according the Centers for Disease Control and Prevention. In Chicago there were 33,901 cases of HIV as of 2008, the most recently available data.
That data helps provide a roadmap for the health care community trying to prevent spread of the disease.
Prachand said that social factors, along with economic and physical environment also play strong roles in distinguishing at-risk urban heterosexuals. Many of the social factors are linked to poverty.
Nearly 22 percent of Chicago residents live at or below the national poverty level, with the highest rates in neighborhoods like East Garfield Park, North Lawndale and West Englewood, according to census tract data.
In Prachand’s study, which surveyed 514 Chicago residents, nearly 1 percent tested positive for HIV at the outset of the study. Of those, 306 reported a yearly income of less than $10,000. The federal poverty level for a two-person household is $14,570.
The survey also included questions on social causes, such as education level, employment status, homelessness, marital status and access to health care.
About 19 percent of the females interviewed said they had male partners who were incarcerated at the time of the survey. Many of them said they had sex with an outside partner while their partner was in jail to help with living expenses.
“This is a very powerful lesson to learn, that so much of public health is dependent on social determinants,” said Caswell Evans, Jr, a member of the city Board of Health. “Unless you get on top of these social issues, it’s tough to turn disease around.”
These matters, along with individual behavior change, need to be addressed when considering prevention planning, Prachand said.
“We need to train healthcare providers to understand that there are more factors at play in health that can’t be controlled.”
Prevention efforts should be focused on reducing unprotected sex and substance abuse, he said, as well as increasing HIV testing and knowledge of status.