Identifying Geographic Areas of Washington, DC, With Increased Potential for Sexual HIV Transmission Among People With HIV With STIs and Concurrent Elevated HIV RNA: Data From the DC Cohort

Authors

Morgan Byrne, Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Hana Akselrod, Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Anne K. Monroe, Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Michael Horberg, Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, Maryland, USA.
Jose Lucar, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Amanda D. Castel, Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Rachel Denyer, Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Rupali Doshi, DC Department of Health, HIV/AIDS, Hepatitis, STD, and TB Administration, Washington, DC, USA.
Alessandra Secco, Northwest Infectious Disease Consultants, Niles, Illinois, USA.
Leah Squires, Department of Psychology, DC Veterans Affairs Medical Center, Washington, DC, USA.
Stefanie Schroeter, Infectious Diseases Section, DC Veterans Administration Medical Center, Washington, DC, USA.
Debra Benator, Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Document Type

Journal Article

Publication Date

5-1-2022

Journal

Open forum infectious diseases

Volume

9

Issue

5

DOI

10.1093/ofid/ofac139

Keywords

HIV; HIV RNA; geospatial; sexually transmitted infection

Abstract

Background: The Undetectable = Untransmittable (U = U) campaign advances the goal of ending the HIV epidemic by promoting durable viral suppression and therefore reducing sexual transmission. We used geospatial analysis to assess the potential for sexual HIV transmission by ZIP code of residence in the District of Columbia (DC) using data from the DC Cohort Longitudinal HIV Study (DC Cohort), a city-wide cohort of persons with HIV (PWH). Methods: DC Cohort participants aged ≥13 years were included in the study period between April 1, 2016, and March 31, 2018. Potential for sexual HIV transmission was defined as the proportion of participants with incident sexually transmitted infection (STI; gonorrhea, chlamydia, syphilis) and with HIV RNA ≥200 copies/mL from 9 months before to 3 months after STI diagnosis. We performed geographic information system (GIS) analysis to determine the ZIP codes with the highest potential for sexual HIV transmission. Results: Of 3467 participants, 367 (10.6%) had at least 1 incident STI, with 89.4% residing in 11 of the 20 residential ZIP codes in DC. Of the 367 participants with an incident STI, at least 1 HIV RNA was available for 348 (94.8%). Ninety-seven (27.9%) individuals with an incident STI had HIV RNA ≥200 copies/mL in the defined time window. Of these 97, 66 (68.0%) resided in 5 of the 20 DC ZIP codes. Conclusions: In DC, 5 ZIP codes of residence accounted for the majority of the estimated potential for HIV transmission among participants in the DC Cohort. These results support focused neighborhood-level interventions to help end the HIV epidemic.

APA Citation

Byrne, Morgan; Akselrod, Hana; Monroe, Anne K.; Horberg, Michael; Lucar, Jose; Castel, Amanda D.; Denyer, Rachel; Doshi, Rupali; Secco, Alessandra; Squires, Leah; Schroeter, Stefanie; and Benator, Debra, "Identifying Geographic Areas of Washington, DC, With Increased Potential for Sexual HIV Transmission Among People With HIV With STIs and Concurrent Elevated HIV RNA: Data From the DC Cohort" (2022). GW Authored Works. Paper 576.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/576

Department

School of Medicine and Health Sciences Student Works