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Author Notes:

Corresponding Author: Sharoda Dasgupta, PhD, MPH, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, Phone: 1 5124841667, Fax: 1 8663118234, Email: sdasgu4@emory.edu

Conflicts of Interest: None declared.


Research Funding:

The National Institute of Mental Health (grant number R01MH085600), Eunice Kennedy Shriver National Institute for Child Health and Human Development (grant number R01HD067111), Emory University Center for AIDS Research (grant number P30AI050409), and Professional Development Support Funds provided by Laney Graduate School, Emory University financially supported the Engage Study.


  • HIV care
  • commuting patterns
  • men who have sex with men
  • public transportation

The Effect of Commuting Patterns on HIV Care Attendance Among Men Who Have Sex With Men (MSM) in Atlanta, Georgia.


Journal Title:

JMIR public health and surveillance


Volume 1, Number 2


, Pages e10-e10

Type of Work:

Article | Final Publisher PDF


BACKGROUND: Travel-related barriers to human immunodeficiency virus (HIV) care, such as commute time and mode of transportation, have been reported in the United States. OBJECTIVE: The objective of the study was to investigate the association between public transportation use and HIV care attendance among a convenience sample of Atlanta-based, HIV-positive men who have sex with men (MSM), evaluate differences across regions of residence, and estimate the relationship between travel distance and time by mode of transportation taken to attend appointments. METHODS: We used Poisson regression to estimate the association between use of public transportation to attend HIV-related medical visits and frequency of care attendance over the previous 12 months. The relationship between travel distance and commute time was estimated using linear regression. Kriging was used to interpolate commute time to visually examine geographic differences in commuting patterns in relation to access to public transportation and population-based estimates of household vehicle ownership. RESULTS: Using public transportation was associated with lower rates of HIV care attendance compared to using private transportation, but only in south Atlanta (south: aRR: 0.75, 95% CI 0.56, 1.0, north: aRR: 0.90, 95% CI 0.71, 1.1). Participants living in south Atlanta were more likely to have longer commute times associated with attending HIV visits, have greater access to public transportation, and may live in areas with low vehicle ownership. A majority of attended HIV providers were located in north and central Atlanta, despite there being participants living all across the city. Estimated commute times per mile traveled were three times as high among public transit users compared to private transportation users. CONCLUSIONS: Improving local public transit and implementing use of mobile clinics could help address travel-related barriers to HIV care.

Copyright information:

© Sharoda Dasgupta, Michael R Kramer, Eli S Rosenberg, Travis H Sanchez, Landon Reed, Patrick S Sullivan.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 2.0 Generic License (http://creativecommons.org/licenses/by/2.0/).

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