A systematic review of the geospatial barriers to antiretroviral initiation, adherence and viral suppression among people living with HIV

Card, Kiffer G.; Lachowsky, Nathan J.; Althoff, Keri N.; Schafer, Katherine R; Hogg, Robert S.; Montaner, Julio S. G.

doi:10.1071/sh18104

Cited by 11 publications

(6 citation statements)

References 73 publications

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“…Most of the research examining the relationship between discrimination based on race/ethnicity and health outcomes focuses primarily on urban and suburban populations, but some of the same implications are applicable to rural areas. As an example, a recent review of Antiretroviral therapy (ART) initiation delays found racial segregation and, to some extent, rural residence, associated with delayed initiation of care and subsequent adherence [53]. The interplay of social segregation and discrimination and health in rural settings is generally complex [54,55].…”

Section: Racism and Ethnocentrismmentioning

confidence: 99%

Improving Sexual Health in U.S. Rural Communities: Reducing the Impact of Stigma

et al. 2021

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Sexually transmitted infections (STI), including HIV, are among the most reported diseases in the U.S. and represent some of America's most significant health disparities. The growing scarcity of health care services in rural settings limits STI prevention and treatment for rural Americans. Local health departments are the primary source for STI care in rural communities; however, these providers experience two main challenges, also known as a double disparity: (1) inadequate capacity and (2) poor health in rural populations. Moreover, in rural communities the interaction of rural status and key determinants of health increase STI disparities. These key determinants can include structural, behavioral, and interpersonal factors, one of which is stigma. Engaging the expertise and involvement of affected community members in decisions regarding the needs, barriers, and opportunities for better sexual health is an asset and offers a gateway to sustainable, successful, and non-stigmatizing STI prevention programs. Keywords Sexually transmitted infections • Stigma • Rural populations • Community engagement ResumenLas infecciones de transmisión sexual (ITS), incluyendo al VIH, se encuentran entre las enfermedades más diagnosticadas en los Estados Unidos y representan algunas de las disparidades de salud más significativas. La creciente escasez de servicios de atención médica en entornos rurales limita la prevención y el tratamiento de las ITS para los estadounidenses de zonas rurales. Los departamentos locales de salud son las fuentes principales para el cuidado de las ITS en las comunidades rurales, pero estos proveedores confrontan dos desafíos principales, o una doble disparidad: (1) capacidad inadecuada y (2) malas condiciones de salud entre las poblaciones rurales. Además, en las comunidades rurales la interacción entre el estatus rural y determinantes claves de la salud aumentan las disparidades asociadas a las ITS. Estos determinantes clave pueden incluir factores estructurales, de comportamiento y interpersonales, como el estigma. El involucrar la experiencia y la participación de los miembros de la comunidad afectados en las decisiones sobre las necesidades, barreras y oportunidades para una mejor salud sexual es beneficioso y ofrece una puerta de entrada a programas de prevención de ITS sostenibles, exitosos y no estigmatizantes. Palabras ClaveInfecciones de transmisión sexual • Estigma • Poblaciones rurales • Participación comunitaria

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Section: Racism and Ethnocentrismmentioning

confidence: 99%

Improving Sexual Health in U.S. Rural Communities: Reducing the Impact of Stigma

et al. 2021

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“…Tian et al [ 7 ] have analyzed the impact of urbanization on the prevalence of scarlet fever. Card et al [ 8 ] reviewed the application of geographic information systems in HIV and emphasized the need for careful planning of resources concerning the geospatial movement and location of people living with HIV. Therefore, this study uses a Bayesian spatiotemporal model to analyze the impact of relevant data on the spatiotemporal distribution of HIV in Luzhou from 2011 to 2020 and provide a point of reference for the precise prevention and control of HIV in other prefecture-level cities in southwest China.…”

Section: Introductionmentioning

confidence: 99%

The Distribution of HIV and AIDS Cases in Luzhou, China, From 2011 to 2020: Bayesian Spatiotemporal Analysis

Ren¹,

Li²,

Wang³

et al. 2022

JMIR Public Health Surveill

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Background The vastly increasing number of reported HIV and AIDS cases in Luzhou, China, in recent years, coupled with the city’s unique geographical location at the intersection of 4 provinces, makes it particularly important to conduct a spatiotemporal analysis of HIV and AIDS cases. Objective The aim of this study is to understand the spatiotemporal distribution of HIV and the factors influencing this distribution in Luzhou, China, from 2011 to 2020. Methods Data on the incidence of HIV and AIDS in Luzhou from 2011 to 2020 were obtained from the AIDS Information Management System of the Luzhou Center for Disease Control and Prevention. ArcGIS was used to visualize the spatiotemporal distribution of HIV and AIDS cases. The Bayesian spatiotemporal model was used to investigate factors affecting the spatiotemporal distribution of HIV and AIDS, including the gross domestic product (GDP) per capita, urbanization rate, number of hospital beds, population density, and road mileage. Results The reported incidence of HIV and AIDS rose from 8.50 cases per 100,000 population in 2011 to 49.25 cases per 100,000 population in 2020—an increase of 578.87%. In the first 5 years, hotspots were concentrated in Jiangyang district, Longmatan district, and Luxian county. After 2016, Luzhou’s high HIV incidence areas gradually shifted eastward, with Hejiang county having the highest average prevalence rate (41.68 cases per 100,000 population) from 2011 to 2020, being 2.28 times higher than that in Gulin county (18.30 cases per 100,000), where cold spots were concentrated. The risk for the incidence of HIV and AIDS was associated with the urbanization rate, population density, and GDP per capita. For every 1% increase in the urbanization rate, the relative risk (RR) increases by 1.3%, while an increase of 100 people per square kilometer would increase the RR by 8.7%; for every 1000 Yuan (US $148.12) increase in GDP per capita, the RR decreases by 1.5%. Conclusions In Luzhou, current HIV and AIDS prevention and control efforts must be focused on the location of each district or county government; we suggest the region balance urban development and HIV and AIDS prevention. Moreover, more attention should be paid to economically disadvantaged areas.

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“…A recent review highlighted the geospatial variation in ART success and inequitable distribution of HIV care in racially segregated, economically disadvantaged, and increasingly rural areas [ 123 ]. It also highlighted the utility and limitations of using GIS to monitor health and HIV treatment outcomes and the need for careful planning of resources with respect to the geospatial movement and location of PLWH [ 123 ]. Many studies in this review in part or wholly used composite scores to describe neighborhood characteristics.…”

Section: Discussionmentioning

confidence: 99%

Neighborhood characteristics and HIV treatment outcomes: A scoping review

Kimaru,

Habila,

Mantina

et al. 2024

PLOS Glob Public Health

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Recognizing challenges faced by people living with HIV is vital for improving their HIV treatment outcomes. While individual-level interventions play a crucial role, community factors can shape the impact of individual interventions on treatment outcomes. Understanding neighborhood characteristics’ association with HIV treatment outcomes is crucial for optimizing effectiveness. This review aims to summarize the research scope on the association between neighborhood characteristics and HIV treatment outcomes. The databases PubMed, CINAHL (EBSCOhost), Embase (Elsevier), and PsychINFO (EBSCOhost) were searched from the start of each database to Nov 21, 2022. Screening was performed by three independent reviewers. Full-text publications of all study design meeting inclusion criteria were included in the review. There were no language or geographical limitations. Conference proceedings, abstract only, and opinion reports were excluded from the review. The search yielded 7,822 publications, 35 of which met the criteria for inclusion in the review. Studies assessed the relationship between neighborhood-level disadvantage (n = 24), composition and interaction (n = 17), social-economic status (n = 18), deprivation (n = 16), disorder (n = 8), and rural-urban status (n = 7) and HIV treatment outcomes. The relationship between all neighborhood characteristics and HIV treatment outcomes was not consistent across studies. Only 7 studies found deprivation had a negative association with HIV treatment outcomes; 6 found that areas with specific racial/ethnic densities were associated with poor HIV treatment outcomes, and 5 showed that disorder was associated with poor HIV treatment outcomes. Three studies showed that rural residence was associated with improved HIV treatment outcomes. There were inconsistent findings regarding the association between neighborhood characteristics and HIV treatment outcomes. While the impact of neighborhood characteristics on disease outcomes is highly recognized, there is a paucity of standardized definitions and metrics for community characteristics to support a robust assessment of this hypothesis. Comparative studies that define and assess how specific neighborhood indicators independently or jointly affect HIV treatment outcomes are highly needed.

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A systematic review of the geospatial barriers to antiretroviral initiation, adherence and viral suppression among people living with HIV

Cited by 11 publications

References 73 publications

Improving Sexual Health in U.S. Rural Communities: Reducing the Impact of Stigma

Improving Sexual Health in U.S. Rural Communities: Reducing the Impact of Stigma

The Distribution of HIV and AIDS Cases in Luzhou, China, From 2011 to 2020: Bayesian Spatiotemporal Analysis

Neighborhood characteristics and HIV treatment outcomes: A scoping review

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