Geospatial factors in HIV prevention trial outcomes

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DESCRIPTION (provided by applicant): This award funds an intensive period of mentored training in geospatial conceptualization and analysis with a focus on an application to HIV prevention trials; the mentor is Dr. Ellen K. Cromley, internationally known for her scholarship relating geospatial factors public health outcomes. Geographical information systems (GIS) have emerged as a powerful scientific tool that can be brought to bear on practically any branch of science. Acquired immunodeficiency syndrome (AIDS), which is caused by HIV, remains a very serious threat to world public health. With no vaccines or other medical cures available, behavior change to lower the risk of acquiring or spreading HIV remains the key to public health. In response, studies relevant to HIV risk-reduction burgeoned, with inconsistencies among study findings complicating easy interpretation. Meta-analyses of prevention trials have documented not only their typical efficacy but also certain factors that relate to their success, yet, to date such reviews have not utilized GIS-related information such as economic and political factors. HIV prevention trials have been conducted in extremely diverse locales across practically every country at all affected by the HIV/AIDS pandemic. On substantive goal of this project is to assemble a geospatial landscape of HIV prevention efficacy evidence, which will literally map when and where trials have been conducted and how well they have achieved prevention goals, examining as well specific facets of the trials and their samples. The landscape in turn will permit an examination of geospatial- temporal factors related to the locales in which the trials were conducted. Two other substantive goals are to pursue meta-analyses of trial efficacy within the United States and with Africa. The training activities will be undertaken while simultaneously assembling the landscape of HIV prevention and then relating geospatial-temporal information to trial efficacy. PUBLIC HEALTH RELEVANCE: Narrative This proposal has extremely high relevance to public health in that its studies review the evidence available regarding interventions to prevent the spread of HIV among the population. The project will yield valuable information about when and where trials have been conducted and with what consequences.