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AIDS Behav. 2019 Jul 18. doi: 10.1007/s10461-019-02609-2. [Epub ahead of print]

Location of Pre-exposure Prophylaxis Services Across New York City Neighborhoods: Do Neighborhood Socio-demographic Characteristics and HIV Incidence Matter?

Author information

1
Department of Population Health, School of Medicine, New York University, 180 Madison Ave, 3rd Floor, New York, NY, 10016, USA. byoungjun.kim@nyulangone.org.
2
Department of Population Health, School of Medicine, New York University, 180 Madison Ave, 3rd Floor, New York, NY, 10016, USA.
3
Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY, USA.

Abstract

Despite an increasing pre-exposure prophylaxis (PrEP) use among populations at highest risk of HIV acquisition, comprehensive and easy access to PrEP is limited among racial/ethnic minorities and low-income populations. The present study analyzed the geographic distribution of PrEP providers and the relationship between their location, neighborhood characteristics, and HIV incidence using spatial analytic methods. PrEP provider density, socio-demographics, healthcare availability, and HIV incidence data were collected by ZIP-code tabulation area in New York City (NYC). Neighborhood socio-demographic measures of race/ethnicity, income, insurance coverage, or same-sex couple household, were not associated with PrEP provider density, after adjusting for spatial autocorrelation, and PrEP providers were located in high HIV incidence neighborhoods (P < 0.01). These findings validate the need for ongoing policy interventions (e.g. public health detailing) vis-à-vis PrEP provider locations in NYC and inform the design of future PrEP implementation strategies, such as public health campaigns and navigation assistance for low-cost insurance.

KEYWORDS:

Neighborhoods; Pre-exposure prophylaxis (PrEP); Spatial analysis; Spatial epidemiology

PMID:
31321639
DOI:
10.1007/s10461-019-02609-2

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