Building the Case for Localized Approaches to HIV: Structural Conditions and Health System Capacity to Address the HIV/AIDS Epidemic in Six US Cities

• Type of Material: Article
• Authors: D. Panagiotoglou, BC Centre for Excellence in HIV/AIDS; M. Olding, BC Centre for Excellence in HIV/AIDS; B. Enns, BC Centre for Excellence in HIV/AIDS; Daniel J. Feaster, University of Miami; Carlos del Rio, Emory University; Lisa R. Metsch, Columbia University; Reuben M. Granich, International Association of Providers of AIDS Care; SA Strathdee, University of California San Diego; Brandon D.L. Marshall, Brown School of Public Health; Matthew R. Golden, University of Washington; Steven Shoptaw, University of California Los Angeles; Bruce R. Schackman, Weill Cornell; Bohdan Nosyk, Simon Fraser University
• Language: English
• Date: 2018-09-01
• Publisher: Springer/Plenum Publishers
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
• Final Published Version (URL): http://dx.doi.org/10.1007/s10461-018-2166-6
• Title of Journal or Parent Work: AIDS and Behavior
• Volume: 22
• Issue: 9
• Start Page: 3071
• End Page: 3082
• Grant/Funding Information: National Institutes on Drug Abuse, grant no. R01- DA041747.
• Keywords: Science & Technology; Public, Environmental & Occupational Health; Health system; CONTINUUM; Social Sciences, Biomedical; UNITED-STATES; DRUG-USERS; Social Sciences; EXPOSURE; PROGRAMS; CARE; Biomedical Social Sciences; PREVENTION; Life Sciences & Biomedicine; HIV; PUBLIC-HEALTH; Epidemiology; CALIFORNIA; Policy; TRANSMISSION
• Research Categories: Biology, Biostatistics; Health Sciences, Epidemiology; Health Sciences, Medicine and Surgery

Abstract

Since the discovery of the secondary preventive benefits of antiretroviral therapy, national and international governing bodies have called for countries to reach 90% diagnosis, ART engagement and viral suppression among people living with HIV/AIDS. The US HIV epidemic is dispersed primarily across large urban centers, each with different underlying epidemiological and structural features. We selected six US cities, including Atlanta, Baltimore, Los Angeles, Miami, New York, and Seattle, with the objective of demonstrating the breadth of epidemiological and structural differences affecting the HIV/AIDS response across the US. We synthesized current and publicly-available surveillance, legal statutes, entitlement and discretionary funding, and service location data for each city. The vast differences we observed in each domain reinforce disparities in access to HIV treatment and prevention, and necessitate targeted, localized strategies to optimize the limited resources available for each city’s HIV/AIDS response.