Socioeconomic geographical links to human immunodeficiency virus seroprevalence among childbearing women in Montreal, 1989-1993

Abstract

Background. To describe the socioeconomic profiles of geographical areas on Montreal Island in which human immunodeficiency virus (HIV) seropositive women delivering live births between 1989 and 1993 reside. Methods. Leftover dried blood spot filter paper specimens collected from newborns were irretrievably unlinked from identifying information prior to testing. Seroprevalence estimates were calculated based on Western blot confirmed positive samples. Using data from the Canadian census, Revenue Canada, and provincial birth records, the socioeconomic characteristics of postal zones in which seropositive mothers reside were described. Results. Montreal Island had an overall 5-year HIV seroprevalence rate estimate of 16.6 (95% CI: 14.1-19.3) per 10,000 childbearing women. Areas in which at least one seropositive woman gave birth had lower mean infant birthweights and higher percentages of single mothers and single-parent families. The HIV-positive neonatal blood specimens were more likely to originate from areas where a higher proportion of residents reported less education, greater unemployment, and lower income. Conclusions. Higher HIV infection rates were found among childbearing women from lower socioeconomic areas of Montreal. Increased understanding of the relationship between socioeconomic status and HIV acquisition and transmission is required to inform the development of targeted HIV prevention programmes.