Evidence for the Role of State-Level Economic Policy in HIV Risk Reduction: State Earned Income Tax Credit Generosity and HIV Risk Behavior Among Single Mothers

Kimberly Danae Cauley Narain; Nina Harawa

doi:10.1007/s10461-022-03754-x

Evidence for the Role of State-Level Economic Policy in HIV Risk Reduction: State Earned Income Tax Credit Generosity and HIV Risk Behavior Among Single Mothers

AIDS Behav. 2023 Jan;27(1):182-188. doi: 10.1007/s10461-022-03754-x. Epub 2022 Jul 1.

Authors

Kimberly Danae Cauley Narain^{1

2

3}, Nina Harawa^{4

5

6}

Affiliations

¹ Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA (DGSOM), University of California, Los Angeles, Los Angeles, CA, USA. KNarain@mednet.ucla.edu.
² Center for Health Advancement, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA. KNarain@mednet.ucla.edu.
³ Center for the Study of Racism, Social Justice, and Health Los Angeles, Los Angeles, CA, USA. KNarain@mednet.ucla.edu.
⁴ Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA (DGSOM), University of California, Los Angeles, Los Angeles, CA, USA.
⁵ Center for the Study of Racism, Social Justice, and Health Los Angeles, Los Angeles, CA, USA.
⁶ Department of Psychiatry, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, USA.

Abstract
in English, Spanish

We investigated the impact of State-level Earned Income Tax Credit (SEITC) generosity on HIV risk behavior among single mothers with low education. We merged individual-level data from the Behavioral Risk Factor Surveillance System (2002-2018) with state-level data from the University of Kentucky Center for Poverty Research and conducted a multi-state, multi-year difference-in-differences (DID) analysis. We found that a refundable SEITC ≥ 10% of the Federal Earned Income Tax Credit was associated with 21% relative risk reduction in reporting any high-risk behavior for HIV in the last year, relative to no SEITC. We also found that a 10-percentage point increase in SEITC generosity was associated with 38% relative risk reduction in reporting any high-risk HIV behavior in the last year. SEITC policy may be an important strategy to reduce the burden of HIV infections among women with low socioeconomic status, particularly single mothers.

Investigamos el impacto de la generosidad del Crédito Federal Tributario por Ingreso de Trabajo a nivel estatal (SEITC) sobre el comportamiento de riesgo al VIH entre madres solteras con baja educación. Unimos los datos a nivel individual del Sistema de Vigilancia a Factores de Riesgo de Comportamiento (2002–2018) con los datos a nivel estatal del Centro de Investigación de la Pobreza de la Universidad de Kentucky, y conducimos un análisis de diferencia-en-diferencia (DID) multi-estado y multi-año. Encontramos que un reembolso SEITC ≥ 10% del Crédito Federal Tributario por Ingreso de Trabajo estaba asociado con una reducción relativa de riesgo de 21% en reportar cualquier comportamiento de riesgo alto al VIH en el último año, relativo a ningún SEITC. También encontramos que un aumento de punto porcentual de 10 en la generosidad SEITC estaba asociado con una reducción relativa de riesgo de 38% en reportar cualquier comportamiento de riesgo alto al VIH en el último año. La póliza SEITC puede ser una estrategia importante para reducir la carga de infecciones al VIH entre mujeres con bajo nivel socioeconómico, particularmente entre madres solteras.

Keywords: HIV; Health equity; Income; Poverty; Risk-taking.

MeSH terms

Female
HIV Infections* / epidemiology
HIV Infections* / prevention & control
Humans
Income
Income Tax*
Risk Reduction Behavior
Risk-Taking
United States / epidemiology

Grants and funding

P30 MH058107/MH/NIMH NIH HHS/United States

Abstract in English, Spanish

MeSH terms

Grants and funding

Abstract
in English, Spanish