Socio-economic differences in HIV/AIDS mortality in South Africa

Charlotte Probst; Charles D H Parry; Jürgen Rehm

doi:10.1111/tmi.12712

Socio-economic differences in HIV/AIDS mortality in South Africa

Trop Med Int Health. 2016 Jul;21(7):846-55. doi: 10.1111/tmi.12712. Epub 2016 May 18.

Authors

Charlotte Probst^{1

2}, Charles D H Parry^{3

4}, Jürgen Rehm^{1

2

5

6

7}

Affiliations

¹ Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.
² Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany.
³ Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.
⁴ Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa.
⁵ Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
⁶ Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
⁷ Department of Psychiatry, University of Toronto, Toronto, ON, Canada.

PMID: 27118253
DOI: 10.1111/tmi.12712

Abstract

Objectives: To quantify socio-economic differences in the risk of HIV/AIDS mortality in South Africa for different measures of socio-economic status.

Methods: Systematic literature search in Web of Knowledge and PubMed. Measures of relative risk (RR) were pooled separately for education, income, assets score and employment status as measures of socio-economic status, using inverse-variance weighted DerSimonian-Laird random effects meta-analyses.

Results: Ten studies were eligible for inclusion comprising over 175 000 participants and 6700 deaths. For income (RR 1.55, 95% confidence interval (CI) 1.15-2.09), assets score (RR 1.63, 95% CI 1.12-2.36) and employment status (RR 1.52, 95% CI 1.21-1.92), persons of low socio-economic status had an over 50% higher risk of dying from HIV/AIDS. The RR of 1.10 for education was not significant (95% CI 0.74-1.65).

Conclusions: Future research should identify effective strategies to reduce HIV/AIDS mortality and alleviate the consequences of HIV/AIDS deaths, particularly for poorer households.

Keywords: AIDS; Afrique du Sud; HIV; SIDA; South Africa; Sudáfrica; VIH; desigualdad; estatus socioeconómico; inequality; inégalité; mortalidad; mortality; mortalité; socio-economic status; statut socioéconomique.

Publication types

Comparative Study
Meta-Analysis
Review

MeSH terms

Acquired Immunodeficiency Syndrome
Adolescent
Adult
Aged
Employment*
Female
HIV Infections / economics
HIV Infections / mortality*
Humans
Income*
Male
Middle Aged
Poverty*
Social Class*
South Africa / epidemiology
Young Adult