This study investigated the association between poverty and new HIV diagnoses in Houston/Harris County, Texas in 2000 and 2010. The results showed that in both years, the rate of new HIV diagnoses was positively associated with increased percentages living below the poverty line. However, the rate ratio between those in extreme poverty (>20% below poverty line) and those with low poverty (5% below poverty line) decreased from 2000 to 2010. Across both years and all poverty levels, males had higher diagnosis rates than females and African Americans remained the most impacted group. The highest rates also shifted to younger age groups living in extreme poverty in 2010, indicating targeted prevention efforts are needed for this underserved population.

1. A Spatial-Temporal Relationship between New HIV Diagnoses and Social
Determinants of Health by Census Tract in Houston/Harris County: 2000 and
2010
Biru Yang1
, Kellie L. Watkins1,2
, Marcia Wolverton1
and Raouf Arafat1
, (1)
Houston Department of Health and Human Services, (2) University of Texas
School of Public Health
BACKGROUND: Poverty, residential stability, and unemployment rates were
associated with the number of newly HIV diagnosed residents in 2008 and 2009
in Houston/Harris County.
METHODS: This study aims to investigate the association between poverty and
new HIV diagnoses in Houston/Harris County, TX. The data was extracted from
the Enhanced HIV/AIDS Reporting System (eHARS) and linked to Census
variables using residential address at HIV diagnosis in 2000 and 2010. Sex, age,
and race/ethnicity were considered in the analysis. Cases were included in the
analysis if they were first diagnosed with HIV in Houston or Harris County. Cases
were geocoded and analyzed at the census tract level and published only in an
aggregate form. Poverty was defined as percent below poverty which was
categorized into four groups (below 5%, 5-10%, 10-20%, and > 20% below the
poverty line). Rate of HIV diagnosis was defined as the total number of new HIV
diagnoses in a poverty group divided by the total number of individuals in the
corresponding poverty group. Rate ratio was defined as the rate of HIV new
diagnoses in the population of more than 20% below poverty (extreme poverty)
divided by the rate of HIV new diagnoses in the population of 5% below poverty
per census tract.
RESULTS: In 2000 and 2010, the rate of new HIV diagnosis was positively
associated with increased percentage below poverty in Houston, TX. However,
the rate ratio decreased by half from 2000 (rate ratio=8.20) to 2010 (rate
ratio=4.07). In 2000 and 2010, the rate among males and the rate among
females were highest for the extreme poverty group. Males had higher rates than
females across all poverty levels. For all age groups, rates were the highest
among the extreme poverty group. In 2000, the highest rate was among the 35 to
44 age group living in extreme poverty. In 2010, the highest rate shifted to the 25
to 34 age group living in extreme poverty.
CONCLUSIONS: Our findings suggest that economically disadvantaged
populations were more likely to receive new HIV diagnoses in both 2000 and
2010. Even though the overall rate ratio decreased from 2000 to 2010, African
American remained as the group that was most impacted by HIV across all
poverty groups. The shift in the rate by age groups living in extreme poverty
indicates that younger HIV-infected individuals living in extreme poverty are
underserved and targeted HIV prevention efforts might be most impactful for this
population.