Socioeconomic status and HIV seroprevalence in Tanzania: a counterintuitive relationship

Objective To examine the relationship between multiple dimensions of socioeconomic status (SES) and HIV seroprevalence in Tanzania. Methods Using a large nationally representative sample of 7515 sexually active adults drawn from the 200304 Tanzania HIV/AIDS Indicator Survey, we analysed the relationship between multiple SES measures and HIV seroprevalence using weighted logistic regression models. Results In adjusted models, individuals in the highest quintile of standard of living had increased odds ratio (OR) of being HIV-positive (male: OR 2.38, 95 CI 1.174.82; female: OR 3.74, 95 CI 2.166.49). Occupational status was differentially associated with HIV in men and women; women in professional jobs had higher OR of being HIV-positive (OR 1.54, 95 CI 1.022.38), whereas unemployed men had higher risk of being HIV-positive (OR 3.49, 95 CI 1.438.58). No marked association was found between increasing education and HIV seroprevalence for men (P 0.83) and women (P 0.87). Conclusion Contrary to the prevailing perception that low SES individuals tend to be more vulnerable to HIV-infection, we found a positive association between standard of living and HIV-infection. Strategies aimed at reducing HIV-infection needs to be cognizant of the complex social heterogeneity in the patterns of HIV-infection.