Online Program

Gaps in targeting high-risk communities in alameda county's publicly-funded HIV testing program: A place-based analysis

Monday, November 4, 2013

Ifeoma Udoh, PhD, Programs and Research, Pangaea Global AIDS Foundation, Oakland, CA
Sandra McCoy, PhD, School of Public Health, University of California, Berkeley, Berkeley, CA
Paul Wesson, School of Public Health, Division of Epidemiology, University of California, Berkeley, Berkeley, CA
Neena Murgai, MPH PhD, HIV/AIDS Epidemiology and Surveillance Unit, Alameda County Public Health Department, Oakland, CA
Sarah Gamble, PhD, University Health Center, University of California, Berkeley, Berkeley
Jonathan Giffard, BA, Independant Consultant, Oakland, CA
Barrot Lambdin, MPH PhD, Pangaea Global AIDS Foundation, Oakland, CA
Background: A goal of the National AIDS Strategy is to “intensify HIV prevention efforts in communities where HIV is most heavily concentrated”. In Alameda County, California, HIV burden is highest where racial/ethnic minorities reside. African Americans and Latinos are most at risk for HIV infection, but not routinely accessing testing. Recent funding cuts have reduced availability of testing sites. We analyzed local HIV testing data to identify gaps in provision of HIV testing.

Methods: We analyzed non-identified routine testing data for Alameda County's publicly funded testing sites between-July 2010-July 2011-from the Local Evaluation Online (LEO) system. Fisher's exact tests and logistic regression were used to compare HIV-positivity between racial and risk groups. GIS mapping was used to examine the association between the geographic distributions of positive test results and testing sites utilizing.

Results: Of the total tests conducted (n=6,430), 1.2% were positive. 2.3% of tests with men who have sex with men (MSM) were HIV-positive; MSM were more likely to be HIV-positive than non-MSM males (OR=3.93; 95%CI: 2.08-7.42). African American MSM (5.6%; OR=5.03; 95%CI: 1.72-14.73) and Latino MSM (2.4%; OR=2.32; 95%CI: 1.05-5.16) testers were more likely to be HIV positive than White MSM. In contrast to downtown Oakland, locations such as East and West Oakland with similarly high HIV/AIDS burden had lower volumes of tests and testing sites.

Conclusions: HIV testing programs should consider placement of sites where at-risk populations reside, work, and engage in risky behaviors. Coordinated outreach efforts and social network utilization may assist in targeting high-risk populations.

Learning Areas:

Planning of health education strategies, interventions, and programs

Learning Objectives:
Discuss the use of routine program monitoring HIV testing data to inform availability of testing sites

Keyword(s): Urban Health, Geographic Information Systems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I currently serves as Research Director for our Oakland Late Diagnosis of HIV, NIH supported study. I have extensive experience in implementing international and domestic HIV/AIDS programming in low resource. around the world, including the Caribbean, Asia, and the United States. My research interest include the design and use of rapid assessment and ethnographic methods to inform program development, with emphasis on populations such as male and female sex workers, and people living with HIV/AIDS.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.