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Relationship Found Between HIV Risk & Individual AND Community Level Educational Status

African-American men who have sex with men (MSM) remain at heightened risk for HIV infection and account for the largest number of African-Americans living with HIV/AIDS. It has long been understood that there is a clear and persistent association between poverty, transactional sex behavior, and HIV risk. A new University of Pennsylvania School of Nursing (Penn Nursing) study has investigated how educational status relates to HIV risk in this population.

“We found that study participants were more apt to engage in transactional sex – the exchange of sex for drugs or money — if they did not complete high school and if their neighbors did not complete high school,” said the study’s lead-author, Robin C. Stevens, PhD, MPH, Assistant Professor of Nursing and Director of the Health Equity & Media Lab. The study was recently published in the journal Urban Health.

Transactional sex is an HIV risk behavior directly linked to the informal economic sector, sometimes termed “the street economy.” It is plausible that in undereducated neighborhoods, more residents participate in informal or street economies, as the more formal sectors of employment are inaccessible without a high school diploma. By investigating the role of lived poverty at both the individual and neighborhood level in transactional sex behavior among African-American MSM, the researchers pinpointed a significant association between educational attainment and HIV risk behavior.

“This data provides potential leverage points for both community-level interventions and advocacy for this population, particularly related to transactional sex and education, and will aid HIV prevention efforts that seek to address the contextual constraints on individual risk behavior,” said Stevens.

Co-authors of the study include John B. Jemmott, PhD, Alisa Stephens-Shields, PHD, and Janet Hsu, all of the University of Pennsylvania; Larry Icard, PhD, MSW, and Scott Rutledge, PhD, MSW, both of Temple University College of Public Health; and Ann O’Leary, PhD, Center for Disease Control and Prevention.

 The study was supported in part by the National Institute of Mental Health (R01MH079736).