Urban-rural differentials in the association between HIV infection and poverty in Kenya

The link between HIV infection and poverty has attracted considerable research attention in recent years, but the relationship is rather complex and findings from existing studies remain inconclusive. While some argue that poverty increases vulnerability, existing empirical evidence from sub-Saharan Africa largely support the view that wealthier men and women, especially rural residents, have higher prevalence of HIV. In this paper, we focus on urban/rural differentials in the association between HIV infection and poverty in Kenya. The study is based on secondary analysis of data from the Kenya Demographic and Health Surveys conducted in 2003 and 2008. We apply multilevel logistic regression models, allowing the poverty risk factor to vary across rural and urban communities (i.e. clusters) in Kenya. The results suggest that the urban poor in Kenya have significantly higher odds of HIV infection than their urban non-poor counterparts, despite poverty being associated with a significantly lower risk among rural residents. Interesting urban/rural differentials are observed in poverty risk factor by key demographic and socio-cultural characteristics, including gender disparities and ethnicity. For example, the rich-poor gap among urban residents is wider for women, with poor urban women being particularly vulnerable.