Role of geospatial mapping in the planning of HIV programs

Abstract

Geographic information systems (GIS) tools can be used to understand the spatial distribution of local HIV epidemics but are often underutilized, especially in low-middle income countries. We present characteristics of an HIV epidemic within Hyderabad, a large city in southern India, as a case study to highlight the utility of such data in program planning. Cross-sectional sample recruited using respondent-driven sampling in a cluster-randomized trial. We analyzed data from 2 cross-sectional respondent-driven sampling surveys of MSM in Hyderabad, which were conducted as part of a cluster-randomized trial. All participants were tested for HIV and those positive underwent viral load quantification. ArcGIS was used to create heat maps of MSM distribution using self-reported postal code of residence and combined into larger zones containing at least 200 MSM. Postal code data was available for 661 MSM (66.2%) in the baseline and 978 MSM (97.8%) in the follow-up survey. The proportion of HIV-positive MSM (12.7–15.7%) and prevalence of virally suppressed persons (2.6–8.2%) increased between the 2 surveys. The distribution of all MSM, HIV-positive MSM, and HIV-viremic MSM differed significantly by geographic zone with several zones having higher numbers of HIV-positive and viremic individuals than would be expected based on the distribution of all MSM. The prevalence of HIV and HIV viremia among MSM differed by geographic zones within a city and evolved over time. Such data could be critical to improving program implementation efficiency by accurately targeting resources to population characteristics.

A scoping review of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) people’s health in India

“…Figure 4 shows that 37% (n = 65) of the articles focused on reporting STI/HIV prevalence estimates [30–47] and correlates of HIV-related risk behaviors [48–94] among MSM and TGW. In the 18 studies [30–47] that reported HIV and STI prevalence estimates among MSM and TGW, nine [31-33, 37, 39–42, 45] were conducted in clinical settings, six [30, 34, 35, 38, 43, 46] in community settings, and three [36, 44, 47] in both clinical and community settings. Of these 18 studies, eight [30, 34, 35, 37, 40, 43, 45, 46] reported HIV/STI prevalence and risk factors among MSM, three [36, 39, 44] human papillomavirus (HPV) prevalence among MSM living with HIV, and three [31, 33, 45] reported prevalence of perianal dermatoses, HPV and other STIs (such as syphilis, chlamydia and gonorrhea) among MSM.…”

“…In the 18 studies [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] that reported HIV and STI prevalence estimates among MSM and TGW, nine [31-33, 37, 39-42, 45] were conducted in clinical settings, six [30,34,35,38,43,46] in community settings, and three [36,44,47] in both clinical and community settings. Of these 18 studies, eight [30,34,35,37,40,43,45,46] reported HIV/STI prevalence and risk factors among MSM, three [36,39,44] human papillomavirus (HPV) prevalence among MSM living with HIV, and three [31,33,45] reported prevalence of perianal dermatoses, HPV and other STIs (such as syphilis, chlamydia and gonorrhea) among MSM. Two studies [38,47] reported correlates of HIV incidence among MSM, with one study each reporting Hepatitis C prevalence among MSM living with HIV…”

“…Figure 4 shows that 37% (n = 65) of the articles focused on reporting STI/HIV prevalence estimates [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] and correlates of HIV-related risk behaviors among MSM and TGW.…”

“…Over one-fourth of the articles (27%; n=48) [95-142] reported on stigma, discrimination, violence, and their associations with physical and mental health. Among these, 16 articles focused on stigma-related aspects of LGBTQI+ health [96, 100-102, 109, 110, 112, 114, 119, 124-126, 129, 132, 137, 140], 3 on violence [97, 103,118], 17 on mental health and its correlates, such as quality of life [95,99,105,106,108,111,115,123,127,128,130,131,135,136,138,139,142], two on resilience [122,133] and one article each on coping skills [141] and promoting LGBTQI+ acceptance [134]. Three articles reported on stress [116], perceived psychological impact [120] and violence [121] associated with Section-377 of the Indian Penal Code, which until September 2018 criminalised adult consensual same-sex relationships.…”

“…Solomon et al [30] 2010 721 X X X Ghosh et al [31] 2011 32 X X X Sahastrabuddhe et al [32] 2012 84 X X X Ghosh et al [33] 2012 26 X X X Solomon et al [34] 2015 12,022 X X X Mayer et al [35] 2015 307 X X X Hernandez et al [36] 2016 300 X X X Aggarwal et al [37] 2016 52 X X X Solomon et al [38] 2016 12,022 X X X Raghavendran et al [39] 2017 300 X X X Hussain et al [40] 2018 277 X X X Gupte et al [41] 2011 2,633 X X X X Clipman et al [42] 2020 4,994 X X X Haldar et al [43] 2020 2,584 X X X Hernandez et al [44] 2021 302 X X X Palakkal et al [45] 2020 560 X X X Prabhu et al [46] 2021 1,639 X X X Patel et al [47] 2021 20,002 [192] 2020 --X X X Chakrapani et al [193] 2021 360 X X X Bowling et al [194] 2018 67 X X Apoorva et al [195] 2016 8 X X Chithrangathan [196] 2018 1 X X Banerjea [197] 2015 8 X X Bowling et al [198] 2016 20 X X Bowling et al [199] 2018 18 X X Srivastava [200] 2020 25 X X Bowling et al [201] 2019 58 X X X X Bowling et al [202] 2019 33 X X X X Chakrapani et al [203] 2021 27 X X Majumder et al [204] 2021 120 X X X Das [205] 2020 29 X X Joseph et al [206] 2017 205 X X Note: Terminologies for focal populations are derived from original sources, with indigenous sexual and gender identities in italics. GBMSM = Gay, bisexual and other men who have sex with men; TGW = Transgender women; LBWSW = Lesbian, bisexual, and other women who have sex with women; TGM = Transgender men; Ppl with intersex var.…”