1. Table 1: NHBS HET3 Participant Characteristics
Using GIS to Visualize Data from the National HIV Behavioral Surveillance (NHBS) in New Orleans, 2013
Meagan Zarwell, PhD Candidate and Laura Cahill, MPH, MA
Louisiana State University Health Sciences Center School of Public Health
publichealth.lsuhsc.edu
Background
Discussion
Map 1: Using RDS Methods to Recruit Participants from High Risk Areas
NHBS seeks to monitor trends in risk behaviors and HIV testing within populations at elevated risk for HIV infection including men who have sex with men, injection drug users, and heterosexuals (HET). The HET3 cycle recruited heterosexuals living in census tracts with high rates of poverty in New Orleans. Respondents who self-reported being HIV+, men who have sex with men, or injection drug users were excluded from this study in order to examine the specific hard-to-reach heterosexual population living in poverty.
The purpose of this study is to evaluate the goals and methods of NHBS using GIS in order to:
assess the effectiveness of sampling strategy to recruit the NHBS target population
display substance use of participants
visualize HIV testing and home-based testing preferences
Alcohol use, non-injection drug use, HIV testing experiences and testing preferences are all important factors for HIV transmission and prevention. As such, it is important to monitor these behaviors and preferences within populations at higher risk for HIV infection including heterosexuals living in poverty.
Map 1 indicates that the majority of NHBS participants were recruited successfully from the target population. In addition, the geographic spread of participants around the central location of the NO/AIDS office (where the survey was administered) indicates that participants successfully recruited eligible peers from various parts of the city as required by RDS methodology.
Map 2 is useful for monitoring substance use behaviors among participants from specific neighborhoods: alcohol use was more widespread among participants than non-injection drug use. This may be an important finding for future programs aimed at reducing substance use within this population.
Lastly, efforts geared toward HIV testing have historically been provided in clinical settings by health care providers. Recently, the FDA approved home-based rapid testing that can be self-administered. Map 3 shows which neighborhoods have more participants who have never been tested for HIV and their preferences for home-based testing. This map demonstrates both areas that would benefit from novel testing interventions and those in which there may be high acceptance of no cost home-based testing.
Map 2: Substance Use in the Past 12 months
Methods
Using respondent driven sampling methods (RDS), participants were recruited who were at least 18 years of age, residents of Orleans parish, able to take the survey in English and who had sex in the past 12 months.
Respondents were given a survey lasting approximately 45 minutes. The following questions were included in the analysis:
Census tract
Poverty status (calculated by household income and # of persons living in household)
Any alcohol consumption in past 12 months
Any non-injection drugs in the past 12 months
Ever took an HIV test
Willingness to take self-administered home-based test for HIV: “If a research study or the health department mailed you a free home-based HIV test that you could read the result of yourself, would you take it?”
Implications
Mapping NHBS HET3 data is useful to both evaluate the effectiveness of the sampling method employed and to illuminate potential neighborhoods where targeted HIV interventions such as mailed home-based testing services or substance use programs may be appropriate.
Results
Map 3: Testing Density and Home-Based Testing Preferences
Table 1 demonstrates the characteristics of study participants. The majority of the sample were African American (97%) and male (60%). While the ages of participants varied, most had received an HIV test in their life (84%) and consumed alcohol in the past 12 months (74%). Almost half (47%) of those surveyed reported using non-injection drugs in past 12 months. In addition, 81% of participants lived below the poverty line.
The socio-demographic characteristics of the sample demonstrate that NHBS effectively reached the target population of residents from Orleans parish.
Table 1: NHBS HET3 Participant Characteristics
(N =384) %
Race
African American
372
96.9
Other 7
1.8
White
Age
18-29 88
23.7
30-39 92
24.8
40-49
51+ 99
26.7
Gender
Male
230
59.6
Female
156
40.4
Ever tested
Yes
325
84.4 No 60
15.6
Poverty
313
81.1 73
18.9
Alcohol Use
Any
285
73.8
None
101
26.2
Non-Injection Drug Use
182
47.1
204
52.9
Acknowledgement
Thanks to all study participants, NO/AIDS Task Force and the Nola Fresh Project Staff, the Louisiana State University Health Sciences Center School of Public Health, and the Louisiana Office of Public Health HIV/AIDS Division.
This work was in part supported by a Cooperative Agreement # U1BPS from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.