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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.

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2013 Council of State and Territorial Epidemiologists Annual Conference

  • 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.