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336867
GIS-based modeling of the HIV/AIDS epidemic in Ecuador using nationally collected spatiotemporal screening and testing data


Tuesday, November 3, 2015

Miguel Reina-Ortiz, MD, MS, MPH, PhD, Department of Global Health, College of Public Health, University of South Florida, Tampa, FL
Vinita Sharma, MPH, Department of Community and Family Health, College of Public Health, University of South Florida, College of Public Health, Tampa, FL
Ricardo Izurieta, MD, MPH, DrPH, DTM&H, Department of Global Health, Tampa, FL
Background: Ecuador holds a disproportionate burden of HIV in Latin America and reports an increase in HIV/AIDS cases after 2008. It is extremely important to understand HIV/AIDS spatiotemporal dynamics. This study uses GIS-based disease modeling to describe, predict and identify areas of higher HIV activity.

Methods: Nationally collected data on HIV screening, HIV cases and AIDS incidence rates during 2009 and 2010 were used. Descriptive geospatial distribution of each of these variables was conducted. Different interpolation algorithms were tested on their performance to predict HIV/AIDS rates for unsampled geographical locations. Moran’s I-based spatial autocorrelation was conducted to identify areas of significantly higher clustering of HIV cases (Hot Spots).

Results: Overall, AIDS incidence rates were highest in the Coast, mid-level in the Andes and lowest in the Amazon basin. High HIV screening rates were reported in all these regions. Ordinary kriging was the interpolation algorithm that best fit the data. Hot Spot Analysis revealed one foci in Santa Elena Province.

Conclusions/Discussion: It has been suggested that increased screening efforts have led to higher reported HIV/AIDS rates in Ecuador. However, nationally collected data evidences a mismatch between screening and HIV/AIDS rates. The only Hot Spot was found to be in Santa Elena, near the main port and largest city of Ecuador, Guayaquil. This study describes the geospatial distribution and statistically significant association, aggregation and autocorrelation of HIV/AIDS cases in Ecuador. Further research is needed to identify geospatial locations where HIV socio-structural determinants collude to increase HIV/AIDS transmission in the local population.

Learning Areas:

Epidemiology
Other professions or practice related to public health
Program planning
Public health or related research

Learning Objectives:
Describe the geospatial distribution of HIV cases in Ecuador during the year 2009 Describe the geospatial distribution of AIDS incidence rates in Ecuador during the year 2009 Describe the geospatial distribution of HIV screening rate in Ecuador during the year 2009 Simulate and interpolate the expected, non-sampled AIDS incidence rate across the national territory of Ecuador Simulate and interpolate the expected, non-sampled number of HIV cases across the national territory of Ecuador Measure the degree of autocorrelation and estimate autoregressive parameters for AIDS incidence rates in Ecuador during the year 2010 Identify Hot Spots of HIV/AIDS in Ecuador based on nationally collected screening data

Keyword(s): HIV/AIDS, Geographic Information Systems (GIS)

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student and researcher studying HIV/AIDS and associated determinants.
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.

Back to: 4278.0: International Issues in HIV/AIDS