SOCIOECONOMIC INFLUENCES ON THE TRANSMISSION OF HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION - THE HIDDEN RISK

Worldwide, and in pockets of poverty in the United States, there is gr owing evidence that poverty is a major contributor to the spread of hu man immunodeficiency virus infection. Specific socioeconomic forces co ntributing to the spread of the infection include the status of women, prostitution, drug use in poor populations, the role of prisons, econ omic factors that disrupt families, and cultural attitudes. A lack of awareness of or an unwillingness to address the social, cultural, and economic forces contributing to the transmission of the human immunode ficiency virus have hampered attempts to stem the epidemic. A ''social prevention'' strategy is called for in which socioeconomic influences on human immunodeficiency virus transmission can be ameliorated. Prac ticing physicians should be aware of these forces because they profoun dly influence the effectiveness of patient education, prevention, and treatment.