|Using Geographic Information System (GIS) to Identify Clustered Elevated Rates of HIV and Syphilis Co-Infection in Men Who Have Sex with Men (MSM) in Selected Areas in Texas and New York: Comparison and Identification of Core Areas for Targeted Prevention|
Uploaded by: Pocket Masters
Pockets: 2015 (May) Teachers College Columbia University Ed.D. Dissertations, Gottesman Libraries Archive, Historical Dissertations
Tags: Co-Infection, GIS, HIV, Hotspot, MSM, Syphilis
Description/Abstract: Syphilis has become a major problem among men who have sex with men (MSM), nationally and internationally. Many MSM with syphilis are co-infected with HIV. The changing epidemiology of syphilis transmission and its association with HIV among MSM has prompted urgent research.
The purpose of this study was to use spatial analysis for a comparative study of syphilis and HIV co-infection for MSM in the zip codes of: Dallas and Harris counties, Texas; and, Manhattan, New York. In addition, the study utilized techniques of geographic information systems (GIS) and principles of epidemiology to examine demographic factors related to syphilis and HIV incidence. The goal was to gain insight into the association of syphilis and HIV co-infection in the study areas.
Results showed that Dallas County had 433 cases of syphilis and 2,019 cases of HIV aggregated over the three-year period of 2010-2012. Harris County data consisted of 824 cases of syphilis and 2,756 cases of HIV over the same period. Comparatively, Manhattan, New York data (2007 -2013) consisted of 2210 cases of primary and secondary syphilis, and 5517 cases of HIV.
Among diagnosed male cases of MSM, it was for Dallas (MSM HIV 81.72%, MSM Syphilis 74.85 %), Harris (MSM HIV 70.71%, MSM Syphilis 70.37%) and Manhattan, New York (MSM HIV 74.88%, MSM Syphilis 65.93%) that these areas were categorized by risk.
Aggregated syphilis and HIV incidence were mapped. Spatial autocorrelation and SaTScan were used to identify clusters of syphilis and HIV. Demographic variables were analyzed at the zip code level based on the United States 2010 census. Clusters of high syphilis incidence rates and HIV were found to have formed around the same geographic areas. These clusters had higher percentages of cases of MSM with syphilis and HIV (between 61 and 96%).
Geospatial techniques can be effectively used to study syphilis and HIV co-infection in MSM, to target areas (zip codes) to prioritize for intervention, and, when combined with behavioral data from the MSM population, to determine effective interventions to address syphilis and HIV co-infection.