ArticleCMAJ open
Influence of the definition of rurality on geographic differences in HIV outcomes in British Columbia: a retrospective cohort analysis.
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- Years gained, health lost? A population-based cohort study of sex differences in healthy life expectancy among people living with HIV.BMJ open · 2026Article
- Self-reported HIV viral load is reliable and not affected by adverse lived experiences of women living with HIV in British Columbia.HIV medicine · 2025Article
- Evaluating methods to define place of residence in Canadian administrative data and the impact on observed associations with all-cause mortality in type 2 diabetes.BMC medical research methodology · 2025Article
- Life expectancy and mortality among males and females with HIV in British Columbia in 1996-2020: a population-based cohort study.The Lancet. Public health · 2025Article
- Cohort Profile Update: Reflecting back and looking ahead: Updating the Comparative Outcomes and Service Utilization Trends (COAST) Study to include 28 years of linked data from people with and without HIV in British Columbia, Canada.International journal of population data science · 2025Article
- Longitudinal analysis of HIV outcomes for persons living with HIV in non-urban areas in southern Alberta, Canada.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2022Article
- Rural-Urban Differences in Suicide Mortality: An Observational Study in Newfoundland and Labrador, Canada: Différences de la Mortalité Par Suicide en Milieu Rural-Urbain: Une Étude Observationnelle à Terre-Neuve et Labrador, Canada.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2021Review
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Authors and funding
11 authors at 7 institutions in 4 countries.
Funding
Abstract
backgroundImproving rural health is often identified as a priority area for research and policy in Canada. We examined how findings on HIV outcomes (virologic suppression) can vary depending on the definition of rurality used.
methodsWe performed retrospective cohort analyses using the Comparative Outcomes and Service Utilization Trends study population-based cohort of adults (age ≥ 19 yr) living with HIV in British Columbia between Apr. 1, 2012, and Mar. 31, 2013. We performed univariate logistic regression analyses using the following geographic variables to predict HIV virologic suppression: rurality defined by forward sortation area, by Statistical Area Classification and by health authority. We mapped suppression using geographic information systems.
resultsVirologic suppression was observed in 5605 (65.2%) of 8598 participants. In univariate analysis, rurality defined by Statistical Area Classification (odds ratio [OR] 0.73, 95% confidence interval [CI] 0.65-0.82), but not by forward sortation area, was associated with lower odds of suppression. When we examined suppression by health authority, Northern Health had the lowest odds of suppression (OR 0.46, 95% CI 0.36-0.58 compared to Vancouver Coastal Health). Geographic information systems mapping showed poorer suppression in northern areas.
interpretationHealth outcome findings can vary depending on the definition of the geographic variable. When including geographic variables, researchers should carefully consider variable definitions and whether other classification systems, such as north-south, are more appropriate than rurality for their analysis.
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