The Direct Program Impacts of Publicly Available Tools to Visualize Spatial Patterns in HIV infection in the United States: the AIDSVu Experience AIDS 2016 – Durban, South Africa Travis Sanchez, DVM, MPH Emory University Thursday, 21 July 2016

Introduction Limited resources for implementing HIV prevention programs Increase use of high quality data about HIV infections and care outcomes Better optimization of resources and potential for more impact in programs Data need to be accessible (and promoted) to a variety of users

About AIDSVu AIDSVu is a compilation of interactive, online maps that allows users to visually explore the HIV epidemic in the U.S. alongside critical resources such as HIV testing and treatment center locations. AIDSVu’s mission is to make HIV data widely accessible and locally relevant. AIDSVu provides users with an intuitive, visual way to connect with complex information about persons living with diagnosed HIV at national, state and local levels.

Interactive Maps National, State, and Local Maps Persons living with diagnosed HIV by state, county, ZIP Code, census tract, and neighborhood Persons newly diagnosed with HIV by state, county, ZIP Code, census tract, and neighborhood Deaths of persons diagnosed with HIV Social determinants of health (e.g., poverty, insurance, education) HIV transmission modes Service Locators HIV testing and treatment center locations NIH-funded HIV Prevention, Vaccine & Treatment Trials Sites Housing Opportunities for People with AIDS

AIDSVu Cities 2016

Rates of Persons Living with Diagnosed HIV, by Census Tract, Chicago, 2013

Black Rates White Rates Rates of Black & White Persons Living with Diagnosed HIV, by ZIP Code, Chicago, 2013

Use Case #1 Microepidemics and HIV testing Using data to target door-to-door HIV testing in high prevalence areas (Philadelphia) AIDSVu data from city directly Prevalence is relatively stable Fine geographic level (census tract) Tested 3,000 people during pilot 15-fold increase over previous testing Approach now integrated into city-wide response Source: Nunn et al. Geography Should Not Be Destiny: Focusing HIV/AIDS Implementation Research and Programs on Microepidemics in US Neighborhoods. AJPH: May 2014, Vol. 104, No. 5, pp nething.com

AIDSVu County data and HRSA Shortage Areas Challenge for rural care delivery Identified areas in greatest need of new service model Use Case #2 Identify Health Professional Shortages Rates of Persons Living with HIV Health Professional Shortages Areas Sources: AIDSVu and Medical AIDS Outreach of Alabama

Identify Telemedicine Hubs Health Professional Shortages Areas Telemedicine Hubs and Spokes Source: Medical AIDS Outreach of Alabama maoi.org

Mapping the HIV Care Continuum New HIV Diagnoses Late HIV Diagnoses Linkage to HIV Care Linkage to HIV Care Engagement in HIV Care HIV Viral Suppression Maps at the Neighborhood or ZIP Code Level

Use Case #3 Comprehensive HIV Strategy Building the Strategy to End AIDS in Fulton County AIDSVu and HIVContinuum data obtained from the city Mapped alongside social determinants Highlighted structural issues for Fulton County to address in the strategy Identify areas in most need of testing, linkage and engagement services Source: Fulton County Task Force to End HIV/AIDS, 27 June 2016 a). Linkage to care b). Viral suppression c). Car ownership d). Bus stops Source: Goswami et al. JAIDS May 1;72(1):

Poverty, 2012 Thinking about Local Social Drivers of HIV Care in Atlanta Percent HIV Viral Suppression, Care Facilities (red squares), 2012 Numbers of Persons Living with HIV, Care Facilities (red squares) and HOPWA Services (green circles), 2012

(a) Number of HIV cases by ZCTA. (b) Number of major HIV providers within 5 mile driving radius of each census tract. (c) Commute time by car from each census tract to the closest HIV provider (minutes). (d) Commute time by public transit from each census tract to the closest HIV provider (minutes). Published in AIDS Research and Human Retroviruses. May 2015, 31(5): DOI: /aid © Mary Ann Liebert, Inc. Spatial Accessibility to HIV Providers in Atlanta, Georgia Dasgupta Sharoda, Kramer Michael R., Rosenberg Eli S., Sanchez Travis H., and Sullivan Patrick S.

Summary AIDSVu and HIVContinuum data are based on high quality, routinely available surveillance data These tools are highly accessible to multiple types of users Increases utilization of these data for impactful strategies and program implementation

Acknowledgements Patrick Sullivan - PI Cory Woodyatt Elizabeth Pembleton Amy Nunn Public Health – City of Philadelphia Fulton County Department of Health and Wellness Medical AIDS Outreach of Alabama Chicago Department of Public Health Gilead Sciences & MAC AIDS Fund Supported by

Contact Us 17 Sign up to receive AIDSVu news & updates bit.ly/AIDSVUNEWS