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Am J Public Health. 2014 May;104(5):775-80. doi: 10.2105/AJPH.2013.301864.

Geography should not be destiny: focusing HIV/AIDS implementation research and programs on microepidemics in US neighborhoods.

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Amy Nunn and Annajane Yolken are with the School of Public Health and the Warren Alpert Medical School, Brown University, Providence, RI. Annajane Yolken is with the Division of Infectious Diseases, Miriam Hospital, Providence, RI. Blayne Cutler is with the New York City Department of Health and Mental Hygiene. Stacey Trooskin is with the Division of Infectious Diseases, Drexel University College of Medicine, Philadelphia, PA. Phill Wilson is with the Black AIDS Institute, Los Angeles, CA. Susan Little is with the Division of Infectious Diseases, University of California, San Diego. Kenneth Mayer is with the Warren Alpert Medical School, Brown University.


African Americans and Hispanics are disproportionately affected by the HIV/AIDS epidemic. Within the most heavily affected cities, a few neighborhoods account for a large share of new HIV infections. Addressing racial and economic disparities in HIV infection requires an implementation program and research agenda that assess the impact of HIV prevention interventions focused on increasing HIV testing, treatment, and retention in care in the most heavily affected neighborhoods in urban areas of the United States. Neighborhood-based implementation research should evaluate programs that focus on community mobilization, media campaigns, routine testing, linkage to and retention in care, and block-by-block outreach strategies.

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