Spatial Clustering of HIV Prevalence in Atlanta, Georgia, and Population Characteristics Associated With Case Concentrations

In the current report, researchers studied prevalent HIV cases in Atlanta, examining distribution trends and population characteristics at the census tract level that may be associated with clustering effects.

Cluster characteristics (area and internal prevalence) were calculated using Kulldorff's spatial scan method. Logistic regression analyses were performed to analyze sociodemographic variables associated with inclusion in a cluster. Researchers also identified locations of organizations offering voluntary HIV testing and counseling and assessed the average travel time to access the services.

The authors identified one large centralized cluster in downtown Atlanta that contained 60 percent of prevalent HIV cases. HIV prevalence inside the cluster was 1.34 percent, compared with 0.32 percent outside the cluster.

Clustered tracts were associated with higher levels of poverty (OR=1.19), lower density of multi-racial residents (OR=1.85), injection drug use (OR=1.99), men having sex with men (OR=3.01), and MSM and IDU (OR=1.6). Of Atlanta HIV service organizations identified, 42 percent were located in the cluster, and average travel time was 13 minutes by car (SD=9.24).

"The HIV epidemic in Atlanta is concentrated in one large cluster characterized by poverty, [MSM], and IV drug usage," the authors concluded. "Prevention efforts targeted to the population living in this area as well as efforts to address the specific needs of these populations may be most beneficial in curtailing the epidemic within the identified cluster."

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