Despite the fact that biomedical research continues to march towards a cure, HIV continues to spread. Why? Why are there new infections when we can prevent transmission of the virus? Why do people living with HIV in the United States continue to die when we have the treatments that will enable them to lead long, happy lives?

We frequently talk about stigma and a lack of access to healthcare as primary obstacles to ending this epidemic, and commit ourselves to addressing these issues. But one thing we don’t talk about enough is poverty. When it comes to contracting HIV, living in poverty is one of the greatest risk factors of all.

It’s no coincidence that African Americans—only 13 percent of the US population—constitute 46 percent of the people who are newly diagnosed with HIV, and also suffer a poverty rate 11.5 percentage points higher than the nation as a whole.

It’s no coincidence that men who have sex with men account for 65 percent of new HIV infections, and that LGBT men and women are more likely to live in poverty than their heterosexual peers.

It’s no coincidence that injection drug users are more likely to share needles if they are living below the poverty line.

And it’s no coincidence that counties with high HIV rates also have poverty rates nearly 7 percentage points higher than the rest of the country.

Our fight against HIV is inextricably tied to the fight against poverty. Earlier this year, Jim Yong Kim, President of the World Bank Group, said, “Just as money alone is insufficient to end poverty, science is powerless to defeat AIDS unless we tackle the underlying social and structural factors.”

The barriers that prevent us from ending HIV/AIDS are no longer scientific, they are societal. According to the Center for Disease Control and Prevention (CDC), “Poverty can limit access to health care, HIV testing, and medications that can lower levels of HIV in the blood and help prevent transmission. In addition, those who cannot afford the basics in life may end up in circumstances that increase their HIV risk.”

Imagine not knowing your status, and being unable to take a day off work to get tested for fear of losing your job. Imagine having to choose between groceries and the gas required to drive yourself to the HIV clinic, or going without heat so that you can afford to stay on your medication. Worst of all, imagine your financial situation is such that risky behavior like transactional sex feels like the only way you can survive.

Poverty is a disease that affects not only individuals but entire communities. Poorer communities lack the resources to adequately treat and fight the virus. Therefore, regardless of your personal income, living in impoverished areas dramatically increases your vulnerability to HIV.

In 2010 the CDC found that 2.1 percent of heterosexual residents in low-income urban areas are infected with HIV. These are epidemic levels—far higher than the national average of 0.45 percent. Further, the residents in these areas who were living below the poverty line were twice as likely to be infected with HIV as those living above the poverty line. Regardless of race, as incomes fall, the likelihood of being infected with HIV skyrockets, leading the CDC to conclude that “poverty is the single most important demographic associated with HIV infection among inner-city heterosexuals.”

Fortunately, there are organizations that are beginning to make gains in the fight against this trend.

Just as poverty and HIV are inextricably linked, so too must our efforts be to end them.



Medical AIDS Outreach of Alabama (MAO) works in the rural areas of the Black Belt Region of southern Alabama—where rates of HIV infection are alarmingly high—to provide treatment and combat stigma for hundreds of people, 75 percent of whom live in poverty. When transportation from rural areas to urban clinics is too expensive and prevents people from receiving treatment, MAO uses telemedicine to check in with patients and to ensure that they are adhering to their treatment regimen. The Elton John AIDS Foundation supports the MAO community health workers who connect patients in rural areas with the care they need, which is their fundamental right.

The Fortune Society in New York City works with formerly incarcerated individuals to provide housing, job training, and, for those living with HIV, connection to medical treatment. By taking a holistic view of each of their clients, The Fortune Society combats poverty and HIV one person at a time, with the knowledge that one dramatically affects the other. The Elton John AIDS Foundation is a proud funder of this work as well.

Whether fighting AIDS abroad or here at home, the words of Jim Yong Kim ring true: “To end both AIDS and poverty, we need sustained political will, social activism, and an unwavering commitment to equity and social justice.”

Just as poverty and HIV are inextricably linked, so too must our efforts be to end them.