Efforts to fight HIV incidence and mortality should be tailored to the disease’s disproportionate impact on specific urban neighborhoods. A new study, published in the American Journal of Public Health, details how a home address can drastically affect the likelihood someone will both contract HIV and die of AIDS-related causes. Urban minority neighborhoods are particularly hard hit.

A map of Philadelphia shows disparities in HIV incidence and mortality. Areas of high mortality correlate strongly with poverty and percent of minority population.
(Credit: Lindsay Kinkade)

“People of color are disproportionately impacted, and their risk of infection is a function not just of behavior but of where they live and the testing and treatment resources in their communities,” lead author Amy Nunn, ScD, MS, an assistant professor of behavioral and social sciences in the Brown University School of Public Health, said in a release. “Limited health services mean more people who don’t know their HIV status and who are not on treatment. People who don’t have access to treatment are much more likely to infect others. Simply having more people in your sexual network with uncontrolled HIV infection raises the probability that you will come into contact with the virus. This is not just about behavior; this is about access to critical health services.”

The study provides detailed maps of high-incidence minority neighborhoods in New York and Philadelphia that demonstrate that people living in these locations are not just more likely to contract HIV, but also more likely to die of AIDS-related causes as well. This greater mortality risk stands up even when compared with neighborhoods that have a high HIV incidence but that tend to be more affluent and more white. The researchers theorize that this disparity is a result of a lack of access to testing, treatment and care services in the minority neighborhoods.

The study’s authors, which include Phill Wilson, president and CEO of the Black AIDS Institute, argue that efforts to combat the virus should focus more specifically on such hard-hit neighborhoods.

“With the new surveillance tools available to us, we know where the epidemic is down to the census track or ZIP code,” Wilson said in the release. “If we are serious about ending the AIDS epidemic in this country, we need to use those tools to invest in vulnerable communities. Unfortunately, instead of building infrastructure and expanding capacity in poor urban communities, we are dismantling the fragile infrastructure that exists.”

To read the press release, click here.