Presentation Title

Spatial Access to HIV Testing Across the US South

Abstract

Access to HIV testing is a major concern in the US south, particularly in rural areas where disparities are greater. Our objective was to explore the relationship between access to HIV testing facilities, rurality and socioeconomic deprivation. Results showed rural settings were less likely to be within 30 minutes of a HIV testing facility, particularly in more socioeconomically deprived areas.

Proposal Summary

OBJECTIVE: Disparities in access to HIV testing facilities affects early diagnosis, linkage into, and retention in HIV care across the US South. The objective of this study is to examine the associations between access to HIV testing facilities, rurality and socioeconomic area deprivation in the US South. METHODS: In this ecological study, latitude/longitude coordinates for HIV testing facilities were obtained from the Centers for Disease Control. Socioeconomic area deprivation was assessed using the Area Deprivation Index (ADI), designed by the University of Wisconsin-Madison. Rurality was defined using the Rural-Urban Commuting Area Codes (RUCA), obtained from the Economic Research Service of the United States Department of Agriculture. Choropleth maps along with road network distances were calculated in ArcGIS 10.2.2 to evaluate access to testing across the US South. RESEARCH FINDINGS: Among the 16 states in the US southern region, Texas had the highest proportion of census tracts (CTs) in rural areas (42.5%) that fell outside of the designated 30-minute coverage range of a HIV testing facility followed by Alabama (25.4%) and Florida (25.2%). Rural CTs in those states were in the fourth and fifth quintile of the Area Deprivation Index (highest levels of depravity). Among metropolitan areas, West Virginia had the highest proportion of CTs (4.9%) that fell outside the coverage range. Overall, a higher proportion of CTs located in rural areas (14.7%) fell outside the coverage range, nearly three times higher than the second closest area designation, small towns where only 4.75% fell outside the zone. CONCLUSIONS/USE FOR PRACTICE: Census tracts in rural areas were less likely to be within a 30-minute drive time of an HIV testing facility compared to other area designations in the US south, particularly in Texas, Alabama and Florida. Rural areas in those states where considered highly socioeconomically deprived which could contribute to the differences in access to testing. Further assessment is required to determine distance to HIV treatment facilities for persons with HIV, and examine the impact on treatment adherence rates. These results can be of value to public health professionals and policy makers planning HIV interventions and policies targeting barriers to HIV care.

Relevance And Significance

Conference Track: HIV/AIDs in rural populations Topic: Clinical Research-Access, retention and care in rural communities Our study relates to the HIV/AIDs in rural populations conference track, primarily the topic of access, retention and care in rural communities in that it focuses on assessing spatial access to HIV testing facilities and emphasizes the significant disparities in access to HIV testing between rural and urban settings in the US south. Lack of access to testing is a major barrier in combating and controlling the spread of HIV by hindering testing, delaying linkage to care and retention for care. Our results are significant in that it provides additional evidence to the claim that there is a major disparity in access to HIV testing in rural settings compared to urban settings in the south. The location for our study is relevant as HIV continues to be a growing issue in the US South and more research is needed to be done to learn and combat the spread of HIV in the region.

Session Format

Poster Session

Keywords

HIV testing, Rural Population Disparities, Spatial Epidemiology

Publication Type and Release Option

Presentation (Open Access)

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Sep 21st, 5:30 PM Sep 21st, 7:30 PM

Spatial Access to HIV Testing Across the US South

Access to HIV testing is a major concern in the US south, particularly in rural areas where disparities are greater. Our objective was to explore the relationship between access to HIV testing facilities, rurality and socioeconomic deprivation. Results showed rural settings were less likely to be within 30 minutes of a HIV testing facility, particularly in more socioeconomically deprived areas.