AIDSVu is an online project that provides interactive, online maps illustrating the impact of HIV across the United States. Using the latest publicly available data at the city, state, and county levels, the new maps visualize disparities in HIV infections and mortality, both geographically and among different demographics. The project, undertaken by researchers at Emory University’s Rollins School of Public Health in partnership with Gilead Sciences, is now in its sixth year.

“The maps are really designed to let people understand more about HIV where they live that's intuitive to people,” explained Patrick Sullivan, an epidemiologist at the Rollins School of Public Health and principal researcher for AIDSVu. “Our health departments and the Centers for Disease Control and Prevention (CDC) do a great job of collecting really high quality data but usually they're put out in cables of data. We felt like the ability to see data in maps would let people zoom in on the areas of interest to them and make it a little more understandable.”

According to Sullivan, the expansions in capacity, not only in geographical coverage but also in terms of data mapped, will offer more insight into changing shape of the epidemic. “This year we are offering more data about new diagnoses at the city level, and we are offering additional information about mortality related to HIV. Those are key indicators for an overall understanding of the epidemic.”

“Our earlier maps were prevalence of HIV cases or people living with HIV,” he explained, “and compared to that new diagnosis let us see a little more about what's happening currently with the epidemic. Deaths among people living with HIV are a good, high-level indicator of how well we are doing with helping people who are living with HIV learn of their status and get into care and get the maximal benefits from care.”

As of this year’s update, AIDSVu now maps county-level data for forty-eight states, and ZIP code-level maps showing HIV prevalence for six new cities have been added, for a total of 40 U.S. cities that represent more than 60 percent of the U.S. HIV epidemic. Among the six new cities is Nashville/Davidson County.

The reality illustrated so clearly by the maps is stark. “It's clear that, when you look at the maps,” Sullivan said, “even on first glance… The Southern U.S. has about 37% of the country's population, but half of all new diagnoses and nearly half of all deaths in people living with HIV. That just speaks to the disproportionate impact in the South.”

Overall, there are other disturbing trends in the data. From 2008-2014, “Overall in the US new diagnoses decreased by about 11%, but during that same period of time new diagnoses among 13-24-year-olds increased by 11%... When you apply that to young men who have sex with men (MSM) particularly, that increase was 27% in that same period. So it just lets us see over time what are the populations for whom diagnoses are still increasing. Despite the national progress there are still some populations that are not sharing in that benefit, and that's young folks and particularly young MSM.”

The AIDSVu maps provide more than illustrations however. They can be important tools for shaping policy, especially at the state and local levels, particularly in places like Nashville where the ZIP code level maps are available. “I like to think of HIV surveillance data in general, and what we provide at AIDSVu in particular, as a roadmap to how to get the most out of our prevention programs,” Sullivan explained. “The maps allow us to see, within a city, down to a smaller, finer geographic level, which areas might be in most need of services.”

Two examples provide some insight into the exciting possibilities now available to Nashville. A program in Philadelphia doing door-to-door HIV testing used maps from AIDSVu to prioritize locations where it would offer HIV testing.

“The idea here,” Sullivan said, “is that ... because most sexual partnerships happen between people who are relatively close geographically, so areas of high HIV prevalence are also areas where we would want to have a high offering of HIV tests to folks who don't know their HIV status. And so there the maps were used to target essentially a testing intervention.”

Another interesting case comes from Alabama. “A community-based organization that focused on providing medical services to people living with HIV used the maps to identify basically gaps in medical provider services,” Sullivan said. “So they looked to see where the very heavily impacted counties were, and then they matched that up with a map of where there were healthcare provider shortages. They identified some critical areas where we know there are a lot of folks living with HIV and there’s a low capacity for provision of medical services. They targeted those areas to put in telemedicine centers that would link folks living in that area to infectious disease experts in other parts of the state … using data from the AIDSVu maps of Alabama.”

According to Doug Alexander of Nashville CARES, the organization is still exploring the new potential offered by AIDSVu mapping in the local fight against HIV.

The AIDSVu project provides guidance in a number of ways: “One is the section of the website called ‘How Do You AIDSVu?’, which is a place where people can upload information on how they've used data, and so that might be a good example for another, comparable organization,” Sullivan said. “But we also … try to help connect folks with others who have similar programmatic needs, we can produce custom maps that might be for educational materials, or we can suggest map uses that might be most useful based on a programmatic goal. So we definitely are open to being in discussion with people about how they'd like to use the data and making suggestions or making connections.”

Thirty-five years into the epidemic, Sullivan realizes there is no magic bullet, but he does see that his project has the potential to make a tangible impact in the fight. ““The maps on AIDSVu allow for the most in-depth look at the HIV epidemic in the U.S. and enable people working in HIV research, prevention, and care to turn big data into action on the ground. Seeing where changes in the epidemic are happening helps people at the federal, state, and local levels to most effectively deploy resources to stop the spread of HIV.”

For more information about the project, or to view the maps, visit aidsvu.org.

 

 

 

 

 

 

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