Hot or Not: Using Maps to Identify HIV Hotspots

Transcription

1 Hot or Not: Using Maps to Identify HIV Hotspots March 2015 Andrea Vazzano Nena do Nascimento Isabel Brodsky Anita Datar Photo by: Health Policy Project

2 Photo by: Andrea Vazzano, Health Policy Project Agenda Why Maps Matter Identifying Priority Districts in Mozambique Examining Regional HIV Prevalence in Tanzania

3 Source: UCLA School of Public Health, Department of Epidemiology Web site, Jan 2010

4 John Snow s Map: Updated Version Source: John Snow s famous cholera analysis data in modern GIS formats, Robin s Blog,

5 A Call for Action: Taking a Geographic Approach July 2013 Applying geospatial analysis to identify HIV epidemic hotspots has the potential to inform smarter, more strategic resource allocation and programming at the country level. Source: Local Epidemics Issue Brief, UNAIDS,

6 Source: AIDSVu ( Emory University, Rollins School of Public Health. Accessed February 12, 2015.

7 The Right Thing The Right Place The Right Time Source: PEPFAR 3.0,

8 What make Data Geographic? Each distinct geographic entity is assigned a unique geographic identifier How can you map data? Use geographic identifiers such as: district names longitude and latitude street addresses Source: MEASURE Evaluation, GIS Techniques for M&E of HIV/AIDS and Related Programs,

9 Identifying Priority Districts in Mozambique

10 Source: Geology.com, Map of Mozambique, Contextualizing Mozambique Longer coastline than the East Coast of the United States Almost twice the size of California! Shares a border with six countries

11 HIV in Mozambique Top ten most-affected countries (UNAIDS, 2014) National adult HIV prevalence is 11.5% (AIDS Indicator Survey, 2009) Regional HIV epidemic understanding AIDS Indicator Survey, 2009

12 HIV Response Acceleration Plan Reduce the number of infections by 50% Reduce mother-to-child transmission to 5% Increase the percentage of HIV-positive adults and children on ART to 80% Unpublished Plan for the Acceleration of the Response to HIV/AIDS: Maputo: Mozambique

13 Priority Districts Developed a methodology to find districts with high HIV positivity and low numbers of people on treatment Priority = more than 1,000 HIV-positive patients in need of treatment

14 Zooming In Data Source: AIDS Indicator Survey 2009, Mozambique Ministry of Health PMTCT 2013

15 Priority Districts 2012 and 2014 Legend New Adult Priority Districts 2014 Old Adult Priority Districts 2012 Provinces Data Source: Ministry of Health, Mozambique, PMTCT 2012 & 2014

16 How low can you go? Examining Regional HIV Prevalence in Tanzania

17 Contextualizing Tanzania Located in Eastern Africa Diverse population of 44.9 million (many ethnic, linguistic, and religious groups) Borders eight countries and the Indian Ocean Source: University of Texas at Austin, Perry-Castañeda Library Map Collection,

18 HIV in Tanzania National HIV prevalence is 5.1%* Adult HIV Prevalence by Region Women & Men ages 15-49, 2011 Known regional variations in HIV HPP Goal: Examine variations in HIV prevalence within regions using HIV testing data from facilities *Source: DHS Program, Tanzania HIV/AIDS and Malaria Indicator Survey ,

19 Steps of the Analysis 1 Estimate % of HIV positivity using prevention of motherto-child transmission testing data at each health facility 2 Use HIV positivity to estimate HIV prevalence at each facility 3 Estimate HIV prevalence for entire region by using interpolation from known HIV prevalence at health facilities

20 HIV Point Prevalence at Health Facilities Legend % HIV point prevalence District Esri, HERE, DeLorme, MapmyIndia, OpenStreetMap contributors, and the GIS user community Annual Report 2013, MOH Tanzania with support from PEPFAR

21 Estimated HIV Prevalence Tanga Legend Light Gray Canvas Reference District % HIV prevalence Value High : 4.5 Low : 0 Light Gray Canvas Base Annual Report 2013, MOH Tanzania with support from PEPFAR Esri, HERE, DeLorme, MapmyIndia, OpenStreetMap contributors, and the GIS user community

22 Estimated HIV Prevalence with Major Roads Overlay Legend Light Gray Canvas Reference TangaRoad District % HIV prevalence Value High : 4.5 Low : 0 Light Gray Canvas Base Kilometers Esri, HERE, DeLorme, MapmyIndia, OpenStreetMap contributors, and the GIS user community Annual Report 2013, MOH Tanzania with support from PEPFAR

23 Next Steps

24 Take Aways HIV epidemics are not uniformly distributed Hotspots within hotspots Mapping is an important tool for decisionmakers Monitoring and management Strategic resource allocation Layering data allows information from multiple sources to be viewed simultaneously

25 Everything happens somewhere, which provides a geographic component to human activity. Mapping shows where and helps develop better questions to understand the why. MEASURE Evaluation Source:

26 Acknowledgments USAID Mai Hijazi Noah Bartlett Emily Roseman OGAC Nate Heard Vanessa Brown Christy Wahle Emily Hughes MISAU, Mozambique National AIDS Control Program, Tanzania Project LEAD, Futures Group Global Fund Jinkou Zhao Ryuichi Komatsu HPP Farley Cleghorn Sarah Clark Suneeta Sharma Ron MacInnis John Stover Ian Wanyeki Lucy Nganga Benard Mitto PEPFAR Tanzania

27 Thank You! The Health Policy Project is a five-year cooperative agreement funded by the U.S. Agency for International Development under Agreement No. AID-OAA-A , beginning September 30, The project s HIV activities are supported by the U.S. President s Emergency Plan for AIDS Relief (PEPFAR). It is implemented by Futures Group, in collaboration with Plan International USA, Avenir Health (formerly Futures Institute), Partners in Population and Development, Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), RTI International, and the White Ribbon Alliance for Safe Motherhood (WRA).