Geospatial Accessibility Factors Influencing HIV Care Continuum Outcomes in South Carolina.

Edith Nnenna Utaka, Xueying Yang, Huiyi Xia, Sicheng Wang, Fanghui Shi, Qingyang Li, Bankole Olatosi, Xiaoming Li

Abstract read

In one paragraph

Article in AIDS and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Edith Nnenna UtakaDepartment of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA. eutaka@email.sc.edu.ORCID http://orcid.org/0000-0002-5574-3229

Xueying YangDepartment of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA.

Huiyi XiaDepartment of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA.

Sicheng WangDepartment of Geography, University of South Carolina, Columbia, USA.

Fanghui ShiDepartment of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA.

Qingyang LiDepartment of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA.

Bankole OlatosiDepartment of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, USA.

Xiaoming LiDepartment of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA.

Funding

Consortium Coordinating Center for Social, Behavioral, and Economic Research on Public Health Emergencies Supplement #2U24AG076462 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI John Kubale, Margaret Catherine Levenstein · 2021 to 2026

$5.9M

NIA NIH HHS U24 AG076462

6 · The paper itself

Abstract

Ending the HIV epidemic in the U.S. requires access to comprehensive care. Traditional measures of service access have focused on distance and time. This study used the enhanced two-step floating catchment area (E2SFCA) method to measure geospatial accessibility and its association with HIV care continuum outcomes. Data from South Carolina's 2020 enhanced HIV/AIDS reporting system (eHARS) were used to calculate aggregated county-level percentage linkage to care (LTC), retention in care (RIC), and viral suppression (VS) among adult people living with HIV (PLWH). E2SFCA was used to measure geospatial accessibility, using the 60-min index as the threshold. County-level mean percentage of dependent variables and covariates were calculated. A linear regression model (LRM) was used to evaluate the association between accessibility index and LTC, RIC, and VS after adjusting for covariates. Accessibility index ranged from 17.9 to 198 across the 46 counties (mean = 67.5, SD = 36.5). Counties with better accessibility were more likely to have a higher percentage of LTC (β = 5.07, 95% CI = 0.83, 9.31) but a lower percentage of VS (β = -2.85, 95% CI= -4.60, -1.10). The negative association between accessibility index and VS was moderated by the percentage of household without vehicle ownership (β = 2.00, 95% CI = 0.02, 4.00). No association was found between the accessibility index and RIC. Counties with lower uninsured rates (β= -3.11, 95% CI= -5.35, -0.87) had higher % LTC. Suboptimal geographic accessibility to HIV care is an important structural barrier in South Carolina. Targeted policies and interventions are needed to address this challenge.

Indexed as

Accessibility factorCounty-levelE2SFCAGeospatial analysisHealth disparitiesHIV care continuumPeople living with HIV/AIDS

Identifiers

PMID42151701

DOI10.1001/jamainternmed.2015.4095

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.