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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”



Inequalities and HIV Infection

Annu. Rev. Public Health. 1997. 18:401-436.


Sally Zierler

Department of Community Health, Brown University School of Medicine, Box G-A4, Providence,

Rhode Island 02912; e-mail:


Nancy Krieger

Department of Health and Social Behavior, Harvard School of Public Health, 677 Huntington

Avenue, Boston, Massachusetts 02115; e-mail:

KEY WORDS: AIDS, gender, racism, poverty, violence

Social inequalities lie at the heart of risk of HIV infection among women in the United States. As of December, 1995, 71,818 US women had developed AIDS-defining diagnoses. These women have been disproportionately poor, African-American, and Latina. Their neighborhoods have been burdened by poverty, racism, crack cocaine, heroin, and violence. To explain which women are at risk and why, this article reviews the epidemiology of HIV and AIDS among women in light of four conceptual frameworks linking health and social justice: feminism, social production of disease/political economy of health, ecosocial, and human rights. The article applies these alternative theories to describe sociopolitical contexts for AIDS' emergence and spread in the United States, and reviews evidence linking inequalities of class, race/ethnicity, gender, and sexuality, as well as strategies of resistance to these inequalities, to the distribution of HIV among women.


Full-text links to some of the citing articles in other journals:

Koenig, L. J., Whitaker, D. J., Royce, R. A., Wilson, T. E., Callahan, M. R., Fernandez, M. I. (2002). Violence During


            Pregnancy Among Women With or at Risk for HIV Infection. Am J Public Health 92: 367-370

Brown-Peterside, P., Rivera, E., Lucy, D., Slaughter, I., Ren, L., Chiasson, M. A., Koblin, B. A. (2001). Retaining

Hard-to-Reach Women in HIV Prevention and Vaccine Trials: Project ACHIEVE. Am J Public Health 91: 1377-1379 [Abstract] [Full Text]  

Estebanez, P. E, Russell, N. K, Aguilar, M D., Béland, F., Zunzunegui, M. V. (2000). Women, drugs and HIV/AIDS: results of a multicentre European study. Int. J. Epidemiol. 29: 734-743 [Abstract] [Full Text]  

Ruiz, J. D, Molitor, F., McFarland, W., Klausner, J., Lemp, G., Page-Shafer, K., Parikh-Patel, A., Morrow, S., Sun, R. K (2000). Prevalence of HIV infection, sexually transmitted diseases, and hepatitis and related risk behavior in young women living in low-income neighborhoods of northern California. eWJM 172: 368-373[Abstract] [Full Text]