Combining geospatial analysis with HIV care continuum to identify differential HIV/AIDS treatment indicators in Uganda

Keywords: Geospatial analysis, HIV care continuum, Viral Suppression, Uganda
Session Type: Virtual Paper
Day: Wednesday
Session Start / End Time: 4/7/2021 01:30 PM (Pacific Time (US & Canada)) - 4/7/2021 02:45 PM (Pacific Time (US & Canada))
Room: Virtual 18

Abstract

To control the HIV epidemic at the population level, ‘90-90-90’ targets have been proposed for sub-Saharan Africa whereby 90% of people living with HIV (PLH) should know their HIV status, 90% of those diagnosed should be receiving antiretroviral therapy (ART), and 90% of those on ART should achieve viral suppression (VS). VS occurs when ART reduces the viral load of PLH to an undetectable level with minimal risk of new infections. We present a two-pronged interdisciplinary analysis, combining geospatial and HIV care continuum techniques, to guide treatment interventions towards achieving the ‘90-90-90’ targets in Uganda. We conducted a spatiotemporal analysis of VS and constructed HIV care-continuums for districts using publicly available data from a centralized laboratory of the Ministry of Health, Uganda. Spatial patterns of VS revealed a distinct east-west pattern of low rates and a north-south pattern of high rates with statistically significant clusters of districts with high and low rates in Southwestern and Eastern Uganda, respectively. VS rates, calculated in a sequential care-continuum framework, revealed local variability as well as a significant gap from the ‘90-90-90’ targets by districts. Such evident local variability of VS may indicate the importance of regionally targeted interventions for bringing the HIV epidemic to an end.