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HIV viral suppression and geospatial patterns of HIV antiretroviral therapy treatment facility use in Rakai, Uganda

OBJECTIVE:To assess geospatial patterns of HIV antiretroviral therapy (ART) treatment facility use and whether they were impacted by viral load suppression. METHODS:We extracted data on the location and type of care services utilized by HIV-positive persons accessing ART between February 2015 and Se... Full description

Journal Title: AIDS (London) 2018, Vol.32 (6), p.819-824
Main Author: Billioux, Veena G
Other Authors: Grabowski, Mary K , Ssekasanvu, Joseph , Reynolds, Steven J , Berman, Amanda , Bazaale, Jeremiah , Patel, Eshan U , Bugos, Eva , Ndyanabo, Anthony , Kisakye, Alice , Kagaayi, Joseph , Gray, Ronald H , Nakigozi, Gertrude , Ssekubugu, Robert , Nalugoda, Fred , Serwadda, David , Wawer, Maria J , Chang, Larry W
Format: Electronic Article Electronic Article
Language: English
Subjects:
HIV
Publisher: England: Copyright Wolters Kluwer Health, Inc
ID: ISSN: 0269-9370
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title: HIV viral suppression and geospatial patterns of HIV antiretroviral therapy treatment facility use in Rakai, Uganda
format: Article
creator:
  • Billioux, Veena G
  • Grabowski, Mary K
  • Ssekasanvu, Joseph
  • Reynolds, Steven J
  • Berman, Amanda
  • Bazaale, Jeremiah
  • Patel, Eshan U
  • Bugos, Eva
  • Ndyanabo, Anthony
  • Kisakye, Alice
  • Kagaayi, Joseph
  • Gray, Ronald H
  • Nakigozi, Gertrude
  • Ssekubugu, Robert
  • Nalugoda, Fred
  • Serwadda, David
  • Wawer, Maria J
  • Chang, Larry W
subjects:
  • Adolescent
  • Adult
  • AIDS
  • AIDS (Disease)
  • AIDS research
  • AIDS/HIV
  • Ambulatory Care - statistics & numerical data
  • Anti-Retroviral Agents - therapeutic use
  • Antiretroviral Therapy, Highly Active
  • Article
  • Cohort Studies
  • distance to clinic
  • Facilities and Services Utilization
  • Female
  • Forecasts and trends
  • global positioning systems
  • Health Services Accessibility - statistics & numerical data
  • Highly active antiretroviral therapy
  • HIV
  • HIV Infections - drug therapy
  • Humans
  • Male
  • Measurement
  • Medical care
  • Medical geography
  • Medicin och hälsovetenskap
  • Middle Aged
  • Patient outcomes
  • Spatial Analysis
  • sub-Saharan Africa
  • Surveys and Questionnaires
  • Uganda
  • Utilization
  • Viral Load
  • Viremia
  • Young Adult
ispartof: AIDS (London), 2018, Vol.32 (6), p.819-824
description: OBJECTIVE:To assess geospatial patterns of HIV antiretroviral therapy (ART) treatment facility use and whether they were impacted by viral load suppression. METHODS:We extracted data on the location and type of care services utilized by HIV-positive persons accessing ART between February 2015 and September 2016 from the Rakai Community Cohort Study in Uganda. The distance from Rakai Community Cohort Study households to facilities offering ART was calculated using the open street map road network. Modified Poisson regression was used to identify predictors of distance traveled and, for those traveling beyond their nearest facility, the probability of accessing services from a tertiary care facility. RESULTS:In total, 1554 HIV-positive participants were identified, of whom 68% had initiated ART. The median distance from households to the nearest ART facility was 3.10 km (interquartile range, 1.65–5.05), but the median distance traveled was 5.26 km (interquartile range, 3.00–10.03, P 
language: eng
source:
identifier: ISSN: 0269-9370
fulltext: no_fulltext
issn:
  • 0269-9370
  • 1473-5571
  • 1473-5571
url: Link


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titleHIV viral suppression and geospatial patterns of HIV antiretroviral therapy treatment facility use in Rakai, Uganda
creatorBillioux, Veena G ; Grabowski, Mary K ; Ssekasanvu, Joseph ; Reynolds, Steven J ; Berman, Amanda ; Bazaale, Jeremiah ; Patel, Eshan U ; Bugos, Eva ; Ndyanabo, Anthony ; Kisakye, Alice ; Kagaayi, Joseph ; Gray, Ronald H ; Nakigozi, Gertrude ; Ssekubugu, Robert ; Nalugoda, Fred ; Serwadda, David ; Wawer, Maria J ; Chang, Larry W
creatorcontribBillioux, Veena G ; Grabowski, Mary K ; Ssekasanvu, Joseph ; Reynolds, Steven J ; Berman, Amanda ; Bazaale, Jeremiah ; Patel, Eshan U ; Bugos, Eva ; Ndyanabo, Anthony ; Kisakye, Alice ; Kagaayi, Joseph ; Gray, Ronald H ; Nakigozi, Gertrude ; Ssekubugu, Robert ; Nalugoda, Fred ; Serwadda, David ; Wawer, Maria J ; Chang, Larry W
descriptionOBJECTIVE:To assess geospatial patterns of HIV antiretroviral therapy (ART) treatment facility use and whether they were impacted by viral load suppression. METHODS:We extracted data on the location and type of care services utilized by HIV-positive persons accessing ART between February 2015 and September 2016 from the Rakai Community Cohort Study in Uganda. The distance from Rakai Community Cohort Study households to facilities offering ART was calculated using the open street map road network. Modified Poisson regression was used to identify predictors of distance traveled and, for those traveling beyond their nearest facility, the probability of accessing services from a tertiary care facility. RESULTS:In total, 1554 HIV-positive participants were identified, of whom 68% had initiated ART. The median distance from households to the nearest ART facility was 3.10 km (interquartile range, 1.65–5.05), but the median distance traveled was 5.26 km (interquartile range, 3.00–10.03, P < 0.001) and 57% of individuals travelled further than their nearest facility for ART. Those with higher education and wealth were more likely to travel further. In total, 93% of persons on ART were virally suppressed, and there was no difference in the distance traveled to an ART facility between those with suppressed and unsuppressed viral loads (5.26 vs. 5.27 km, P = 0.650). CONCLUSION:Distance traveled to HIV clinics was increased with higher socioeconomic status, suggesting that wealthier individuals exercise greater choice. However, distance traveled did not vary by those who were or were not virally suppressed.
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subjectAdolescent ; Adult ; AIDS ; AIDS (Disease) ; AIDS research ; AIDS/HIV ; Ambulatory Care - statistics & numerical data ; Anti-Retroviral Agents - therapeutic use ; Antiretroviral Therapy, Highly Active ; Article ; Cohort Studies ; distance to clinic ; Facilities and Services Utilization ; Female ; Forecasts and trends ; global positioning systems ; Health Services Accessibility - statistics & numerical data ; Highly active antiretroviral therapy ; HIV ; HIV Infections - drug therapy ; Humans ; Male ; Measurement ; Medical care ; Medical geography ; Medicin och hälsovetenskap ; Middle Aged ; Patient outcomes ; Spatial Analysis ; sub-Saharan Africa ; Surveys and Questionnaires ; Uganda ; Utilization ; Viral Load ; Viremia ; Young Adult
ispartofAIDS (London), 2018, Vol.32 (6), p.819-824
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0Billioux, Veena G
1Grabowski, Mary K
2Ssekasanvu, Joseph
3Reynolds, Steven J
4Berman, Amanda
5Bazaale, Jeremiah
6Patel, Eshan U
7Bugos, Eva
8Ndyanabo, Anthony
9Kisakye, Alice
10Kagaayi, Joseph
11Gray, Ronald H
12Nakigozi, Gertrude
13Ssekubugu, Robert
14Nalugoda, Fred
15Serwadda, David
16Wawer, Maria J
17Chang, Larry W
title
0HIV viral suppression and geospatial patterns of HIV antiretroviral therapy treatment facility use in Rakai, Uganda
1AIDS (London)
addtitleAIDS
descriptionOBJECTIVE:To assess geospatial patterns of HIV antiretroviral therapy (ART) treatment facility use and whether they were impacted by viral load suppression. METHODS:We extracted data on the location and type of care services utilized by HIV-positive persons accessing ART between February 2015 and September 2016 from the Rakai Community Cohort Study in Uganda. The distance from Rakai Community Cohort Study households to facilities offering ART was calculated using the open street map road network. Modified Poisson regression was used to identify predictors of distance traveled and, for those traveling beyond their nearest facility, the probability of accessing services from a tertiary care facility. RESULTS:In total, 1554 HIV-positive participants were identified, of whom 68% had initiated ART. The median distance from households to the nearest ART facility was 3.10 km (interquartile range, 1.65–5.05), but the median distance traveled was 5.26 km (interquartile range, 3.00–10.03, P < 0.001) and 57% of individuals travelled further than their nearest facility for ART. Those with higher education and wealth were more likely to travel further. In total, 93% of persons on ART were virally suppressed, and there was no difference in the distance traveled to an ART facility between those with suppressed and unsuppressed viral loads (5.26 vs. 5.27 km, P = 0.650). CONCLUSION:Distance traveled to HIV clinics was increased with higher socioeconomic status, suggesting that wealthier individuals exercise greater choice. However, distance traveled did not vary by those who were or were not virally suppressed.
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0Adolescent
1Adult
2AIDS
3AIDS (Disease)
4AIDS research
5AIDS/HIV
6Ambulatory Care - statistics & numerical data
7Anti-Retroviral Agents - therapeutic use
8Antiretroviral Therapy, Highly Active
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24Medical geography
25Medicin och hälsovetenskap
26Middle Aged
27Patient outcomes
28Spatial Analysis
29sub-Saharan Africa
30Surveys and Questionnaires
31Uganda
32Utilization
33Viral Load
34Viremia
35Young Adult
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6Patel, Eshan U
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8Ndyanabo, Anthony
9Kisakye, Alice
10Kagaayi, Joseph
11Gray, Ronald H
12Nakigozi, Gertrude
13Ssekubugu, Robert
14Nalugoda, Fred
15Serwadda, David
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17Chang, Larry W
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titleHIV viral suppression and geospatial patterns of HIV antiretroviral therapy treatment facility use in Rakai, Uganda
authorBillioux, Veena G ; Grabowski, Mary K ; Ssekasanvu, Joseph ; Reynolds, Steven J ; Berman, Amanda ; Bazaale, Jeremiah ; Patel, Eshan U ; Bugos, Eva ; Ndyanabo, Anthony ; Kisakye, Alice ; Kagaayi, Joseph ; Gray, Ronald H ; Nakigozi, Gertrude ; Ssekubugu, Robert ; Nalugoda, Fred ; Serwadda, David ; Wawer, Maria J ; Chang, Larry W
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12Facilities and Services Utilization
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16Health Services Accessibility - statistics & numerical data
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19HIV Infections - drug therapy
20Humans
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22Measurement
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24Medical geography
25Medicin och hälsovetenskap
26Middle Aged
27Patient outcomes
28Spatial Analysis
29sub-Saharan Africa
30Surveys and Questionnaires
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32Utilization
33Viral Load
34Viremia
35Young Adult
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1Grabowski, Mary K
2Ssekasanvu, Joseph
3Reynolds, Steven J
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5Bazaale, Jeremiah
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8Ndyanabo, Anthony
9Kisakye, Alice
10Kagaayi, Joseph
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13Ssekubugu, Robert
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16Wawer, Maria J
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1Grabowski, Mary K
2Ssekasanvu, Joseph
3Reynolds, Steven J
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5Bazaale, Jeremiah
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7Bugos, Eva
8Ndyanabo, Anthony
9Kisakye, Alice
10Kagaayi, Joseph
11Gray, Ronald H
12Nakigozi, Gertrude
13Ssekubugu, Robert
14Nalugoda, Fred
15Serwadda, David
16Wawer, Maria J
17Chang, Larry W
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atitleHIV viral suppression and geospatial patterns of HIV antiretroviral therapy treatment facility use in Rakai, Uganda
jtitleAIDS (London)
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date2018-03-27
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volume32
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spage819
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pages819-824
issn
00269-9370
11473-5571
eissn1473-5571
notesContributed equally
abstractOBJECTIVE:To assess geospatial patterns of HIV antiretroviral therapy (ART) treatment facility use and whether they were impacted by viral load suppression. METHODS:We extracted data on the location and type of care services utilized by HIV-positive persons accessing ART between February 2015 and September 2016 from the Rakai Community Cohort Study in Uganda. The distance from Rakai Community Cohort Study households to facilities offering ART was calculated using the open street map road network. Modified Poisson regression was used to identify predictors of distance traveled and, for those traveling beyond their nearest facility, the probability of accessing services from a tertiary care facility. RESULTS:In total, 1554 HIV-positive participants were identified, of whom 68% had initiated ART. The median distance from households to the nearest ART facility was 3.10 km (interquartile range, 1.65–5.05), but the median distance traveled was 5.26 km (interquartile range, 3.00–10.03, P < 0.001) and 57% of individuals travelled further than their nearest facility for ART. Those with higher education and wealth were more likely to travel further. In total, 93% of persons on ART were virally suppressed, and there was no difference in the distance traveled to an ART facility between those with suppressed and unsuppressed viral loads (5.26 vs. 5.27 km, P = 0.650). CONCLUSION:Distance traveled to HIV clinics was increased with higher socioeconomic status, suggesting that wealthier individuals exercise greater choice. However, distance traveled did not vary by those who were or were not virally suppressed.
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pubCopyright Wolters Kluwer Health, Inc
pmid29369167
doi10.1097/QAD.0000000000001761
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