ArticleThe Lancet. Global health2020
Travel time to health-care facilities, mode of transportation, and HIV elimination in Malawi: a geospatial modelling analysis.
Article in The Lancet. Global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 34 papers.
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Who cites it
34 citing papers in PubMed.
- A Cluster-Randomized Trial of Traditional Healer-Delivered Counseling and Rapid HIV Testing in Tanzania.AIDS and behavior · 2022Trial
- Evaluating tuberculosis service accessibility in Pakistan by analyzing population movement patterns from telecom mobility and survey data.BMC global and public health · 2026Article
- Continental-scale assessment of spatial food market accessibility in Africa using open geospatial data.Scientific reports · 2026Article
- Quantifying the impact of health service delivery barriers on access to healthcare: a case study of antiretroviral therapy in Mali.BMJ global health · 2026Article
- Suitability and Acceptability of Decentralised Care for People Living with HIV.AIDS and behavior · 2026Article
- Retention in HIV care before and after implementation of a case management program in Malawi.BMC public health · 2026Article
- Spatial modeling of HIV prevalence in Malawi using generalized additive models.Frontiers in epidemiology · 2026Article
- Investigating strategies to enhance access to HIV services among children in Malawi: A multifaceted research approach, study protocol.PloS one · 2026Article
- Human papillomavirus vaccination in rural Malawi: Identifying factors associated with vaccine uptake using a community-based household survey.Human vaccines & immunotherapeutics · 2025Article
- 'You don't need schooling-just take the pills and don't stop.': Pathways between formal education and chronic HIV care in Malawi.SSM. Qualitative research in health · 2025Article
- Applying a systems thinking approach to evaluating the effectiveness of Africa's foodborne disease surveillance systems.Communications medicine · 2025Article
- Identifying the Factors Associated With Spatial Clustering of Incident HIV Infection Cases in High-Prevalence Regions: Quantitative Geospatial Study.JMIR public health and surveillance · 2025Article
- Analysis of travel-time to HIV treatment in sub-Saharan Africa reveals inequities in access to antiretrovirals.Communications medicine · 2025Article
- Extreme geographic misalignment of healthcare resources and HIV treatment deserts in Malawi.Nature medicine · 2025Article
- The potential promise and pitfalls of point-of-care viral load monitoring to expedite HIV treatment decision-making in rural Uganda: a qualitative study.BMC health services research · 2024Article
- Moving beyond hotspots of HIV prevalence to geospatial hotspots of UNAIDS 95-95-95 targets in sub-Saharan Africa.The lancet. HIV · 2024Review
- Article
- Household transport ownership and HIV viral suppression in rural Uganda: a cross- sectional, population-based study.Research square · 2024Article
- Geospatial investigations in Colombia reveal variations in the distribution of mood and psychotic disorders.Communications medicine · 2024Article
- Phone-based psychosocial counseling for people living with HIV: Feasibility, acceptability and impact on uptake of psychosocial counseling services in Malawi.Global mental health (Cambridge, England) · 2024Article
Corrections and comments
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- Erratum issued
Authors and funding
4 authors.
Funding
Abstract
backgroundUNAIDS has prioritised Malawi and 21 other countries in sub-Saharan Africa for fast-tracking the end of their HIV epidemics. UNAIDS' elimination strategy requires achieving a treatment coverage of 90% by 2030. However, many individuals in the prioritised countries have to travel long distances to access HIV treatment and few have access to motorised transportation. Using data-based geospatial modelling, we investigated whether these two factors are barriers to achieving HIV elimination in Malawi and assessed the effect of increasing bicycle availability on expanding treatment coverage.
methodsWe built a data-based geospatial model that we used to estimate the minimum travel time needed to access treatment, for every person living with HIV in Malawi. We constructed our model by combining a spatial map of health-care facilities, a map that showed the number of HIV-infected individuals per km
findingsWe identified a quantitative relationship between the maximum achievable coverage of treatment and the minimum travel time to the nearest health-care facility. At 70% coverage, health-care facilities can be reached within approximately 45 min if driving, 65 min if bicycling, and 85 min if walking. Increasing coverage above 70% will become progressively more difficult. To reach 90% coverage, many HIV-infected individuals (who have yet to initiate treatment) will need to travel for almost twice as long as those already on treatment. Bicycling, rather than walking, in rural areas would substantially increase the maximum achievable coverage.
interpretationThe long travel times needed to reach health-care facilities coupled with little motorised transportation in rural areas are substantial barriers to reaching 90% coverage in Malawi. Increased bicycle availability could help eliminate HIV.
fundingUS National Institute of Allergy and Infectious Diseases.
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