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HIV Influenced by Where You Live

Researchers think the place you live in is as important as your behavior, when it comes to getting HIV. "The risk of individual behavior is enhanced or lessened by the type of place in which it takes place," says Dr. Shelah S. Bloom. She analyzed HIV data from an area in rural Northern Tanzania, but her discoveries can be used to fight AIDS in U.S. neighborhoods and high schools.

She looked individual risk factors for AIDS, such as HIV status, economic status, and recent health and sexual behavior histories. She also looked at risk factors in the communities, such as economic and social activity, population mobility, and distances between rural and urban centers. She found the risk of getting HIV varied across the region in ways that couldn?t be explained solely by individual actions.

HIV infection rates in both men and women were affected by the community in which they lived. A robust and mobile economy seems to elevate a community's HIV risk, because the local population comes into contact with a larger pool of sexual partners, some of whom may be infected. Bloom found that men living in villages with higher rates of economic activity were almost five times more likely to be infected with HIV than those in rural settings who were less involved with trade.

While the researchers say community risk factors did not take the place of individual actions as an explanation for HIV infection rates, they found that individual risk is higher in some areas than in others. Despite many years of AIDS prevention campaigns in Africa, there has not been an increase condom use or less risky behavior, and this may be because there?s been a narrow focus on how individuals behave. Future efforts should focus as much on high-risk places as they do on the behavior of high-risk people.

We know that some areas of the U.S. have more HIV and AIDS than others, but we also focus on changing individual behavior. Maybe we should take a cue from African studies and try to change the way a community works first.

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