Details:

Alternative Title:
J Acquir Immune Defic Syndr
Publisher's site:
http://dx.doi.org/10.1097/QAI.0b013e3182a90112
Personal Author:
Eberhart, Michael G. ; Yehia, Baligh R. ; Hillier, Amy ; Voytek, Chelsea D. ; Blank, Michael ; ... More +
Eberhart, Michael G. ; Yehia, Baligh R. ; Hillier, Amy ; Voytek, Chelsea D. ; Blank, Michael ; Frank, Ian ; Metzger, David S. ; Brady, Kathleen A. Less -
Description:
Background

Successful HIV treatment as prevention requires individuals to be tested, aware of their status, linked to and retained in care, and virally suppressed. Spatial analysis may be useful for monitoring HIV care by identifying geographic areas with poor outcomes.

Methods

Retrospective cohort of 1,704 people newly diagnosed with HIV identified from Philadelphia’s Enhanced HIV/AIDS Reporting System in 2008–2009, with follow-up to 2011. Outcomes of interest were not linked to care, not linked to care within 90 days, not retained in care, and not virally suppressed. Spatial patterns were analyzed using K-functions to identify ‘hot spots’ for targeted intervention. Geographic components were included in regression analyses along with demographic factors to determine their impact on each outcome.

Results

Overall, 1,404 persons (82%) linked to care; 75% (1,059/1,404) linked within 90 days; 37% (526/1,059) were retained in care; and 72% (379/526) achieved viral suppression. 59 census tracts were in ‘hot spots’, with no overlap between outcomes. Persons residing in geographic areas identified by the local K-function analyses were more likely to not link to care (AOR 1.76 [95% CI 1.30–2.40]), not link to care within 90 days (1.49, 1.12–1.99), not be retained in care (1.84, 1.39–2.43), and not be virally suppressed (3.23, 1.87–5.59) than persons not residing in the identified areas.

Conclusion

This study is the first to identify spatial patterns as a strong independent predictor of linkage to care, retention in care, and viral suppression. Spatial analyses are a valuable tool for characterizing the HIV epidemic and treatment cascade.


Subject:
[+]
Adult
Anti-Retroviral Agents
Article
Continuity Of Patient Care
Delivery Of Health Care
Female
Geographic Information Systems
HIV Infections
HIV Seropositivity
Humans
Male
Middle Aged
Philadelphia
Spatial Analysis
Viral Load
Young Adult

Source:
J Acquir Immune Defic Syndr. 64(0 1):S42-S51.
Pubmed ID:
24126447
Pubmed Central ID:
PMC3891372
Document Type:
Journal Article
Funding:
(PS13-130202/PS/NCHHSTP CDC HHS/United States ; 5P30AI087714/AI/NIAID NIH HHS/United States ; K23 MH097647/MH/NIMH NIH HHS/United States ; K23-MH097647/MH/NIMH NIH HHS/United States ; P30 AI045008/AI/NIAID NIH HHS/United States ; ... More +
(PS13-130202/PS/NCHHSTP CDC HHS/United States ; 5P30AI087714/AI/NIAID NIH HHS/United States ; K23 MH097647/MH/NIMH NIH HHS/United States ; K23-MH097647/MH/NIMH NIH HHS/United States ; P30 AI045008/AI/NIAID NIH HHS/United States ; P30-AI-45008/AI/NIAID NIH HHS/United States ; U62/003959/PHS HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:4e60d67ffc1ca493b972bbab0f1ff8366a9e9d6513c22015f2ec11fed5d8777f
File Type:

Supporting Files

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