ArticleInternational journal of health geographics2010
Geospatial analysis of HIV-Related social stigma: a study of tested females across mandals of Andhra Pradesh in India.
Article in International journal of health geographics, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review of public health research on prevention of mother-to-child transmission of HIV in India with focus on provision and utilization of cascade of PMTCT services.BMC public health · 2012Pooled it
- Review
- Finding HIV in hard to reach populations: mobile HIV testing and geospatial mapping in Umlazi township, Durban, South Africa.AIDS and behavior · 2015Article
- Trajectories of Childbearing among HIV Infected Indian Women: A Sequence Analysis Approach.PloS one · 2015Article
- Geospatial analysis on the distributions of tobacco smoking and alcohol drinking in India.PloS one · 2014Article
- Population weighted raster maps can communicate findings of social audits: examples from three continents.BMC health services research · 2011Article
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Authors and funding
6 authors.
Funding
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Abstract
backgroundIn Geographical Information Systems issues of scale are of an increasing interest in storing health data and using these in policy support. National and international policies on treating HIV (Human Immunodeficiency Virus) positive women in India are based on case counts at Voluntary Counseling and Testing Centers (VCTCs). In this study, carried out in the Indian state of Andhra Pradesh, these centers are located in subdistricts called mandals, serving for both registration and health facility policies. This study hypothesizes that people may move to a mandal different than their place of residence for being tested for reasons of stigma. Counts of a single mandal therefore may include cases from inside and outside a mandal. HIV counts were analyzed on the presence of outside cases and the most likely explanations for movement. Counts of women being tested on a practitioners' referral (REFs) and those directly walking-in at testing centers (DWs) were compared and with counts of pregnant women.
resultsAt the mandal level incidence among REFs is on the average higher than among DWs. For both groups incidence is higher in the South-Eastern coastal zones, being an area with a dense highway network and active port business. A pattern on the incidence maps was statistically confirmed by a cluster analysis. A spatial regression analysis to explain the differences in incidence among pregnant women and REFs shows a negative relation with the number of facilities and a positive relation with the number of roads in a mandal. Differences in incidence among pregnant women and DWs are explained by the same variables, and by a negative relation with the number of neighboring mandals. Based on the assumption that pregnant women are tested in their home mandal, this provides a clear indication that women move for testing as well as clues for explanations why.
conclusionsThe spatial analysis shows that women in India move towards a different mandal for getting tested on HIV. Given the scale of study and different types of movements involved, it is difficult to say where they move to and what the precise effect is on HIV registration. Better recording the addresses of tested women may help to relate HIV incidence to population present within a mandal. This in turn may lead to a better incidence count and therefore add to more reliable policy making, e.g. for locating or expanding health facilities.
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