An Analysis of Geography Project Data to Determine HIV and Behavioral Risk for High Risk Zip Codes and Low Risk Zip Codes in Fulton County, GA

Jamaal B. Marshall An Analysis of Geography Project Data to Determine HIV and Behavioral Risk for High Risk Zip Codes and Low Risk Zip Codes in Fulton County, GA (Under the direction of Richard Rothenberg, MPH, MD) INTRODUCTION: The HIV epidemic continues to face new challenges as antiretroviral therapy contributes to the increased prevalence of HIV. HIV disease in the Atlanta, GA area is thought to be clustered in specific areas of the metropolitan area, rather than evenly distributed. A study to show a significantly higher HIV risk in certain geographical areas would be beneficial to the many agencies of the area that allocate significant resources based on zip codes and other geographic factors. AIM: The purpose of this study is to describe the demographics of the study population, describe the demographics of those participants that tested HIV-positive, and perform univariate and multivariate logistic regression analysis to determine the associations between zip code of residence, HIV infection, and risky behavior METHODS: Data were collected by Georgia State University’s Center of Excellence for Health Disparities Research for The Geography Project. HIV disease was determined for each case using data from preliminary and confirmatory tests. Statistical analysis was performed using SPSS. A univariate and multivariate binary logistic regression analysis was performed on select variables. A p-value of < 0.05 and a 95% confidence interval (CI) were used to determine significance. RESULTS: Participants in high risk zip codes were roughly 6.7 times more likely to have been given an HIV-positive result prior to interview when compared to participants in low risk zip codes (OR=6.717, CI=1.989-22.683, p=.000). Furthermore, these same participants were about 4.4 times more likely to be infected with HIV at the time of interview (OR=4.402, CI=2.1099.187, p=.000), and 1.4 times more likely to have more than 3 sex contacts in the 6 months prior to the interview (OR=1.425, CI=1.075-1.890, p=.014). Participants in high risk zip codes were less likely to have experienced incarceration when compared to participants in low risk zip codes (OR=.551, CI=.390-.778, p=.001). The association between HIV and persons that identify as transgender was extremely significant (OR= 28.335, CI=8.305-96.678, p=.000). There was also a significant association between HIV and the high risk zip code group (OR=2.875, CI=1.3306.217, p=.007). DISCUSSION: The results indicated that participants in the high risk zip codes group were at a higher risk for HIV infection and having 3 or more sex contacts in the 6 months prior to the interview. Further analysis is suggested to determine if there is a significant association between geographic distance and partner selection. INDEX WORDS: HIV, high risk zip codes group, low risk zip codes group, spatial distribution An Analysis of Geography Project Data to Determine HIV and Behavioral Risk for High Risk Zip Codes and Low Risk Zip Codes in Fulton County, GA by Jamaal B. Marshall B.A., Georgia State University A Thesis Submitted to the Graduate Faculty of Georgia State University in Partial Fulfillment of the Requirements for the Degree MASTER OF PUBLIC HEALTH ATLANTA, GEORGIA 2012 An Analysis of Geography Project Data to Determine HIV and Behavioral Risk for High Risk Zip Codes and Low Risk Zip Codes in Fulton County, GA by JAMAAL B. MARSHALL