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The end of the line: has rapid transit contributed to the spatial diffusion of HIV in one of Canada's largest metropolitan areas?

Author

Listed:
  • Wood, Evan
  • Chan, Keith
  • Montaner, Julio S. G.
  • Schechter, Martin T.
  • Tyndall, Mark
  • O'Shaughnessy, Michael V.
  • Hogg, Robert S.

Abstract

The objective of this study is to describe the relationship between socio-demographic characteristics and the geographic distribution of persons with HIV in the metropolitan area surrounding Vancouver, British Columbia. Specifically, we sought to determine the location of persons with HIV and the population based characteristics related to the rate of anti-HIV medication use. In addition, we investigated the relationship between the distribution of persons on anti-HIV medications and the city's monorail "SkyTrain" route. The residences of persons on anti-HIV therapy were linked to Census Tracts. Data from the most recent census were used to create a socio-demographic profile of each geographic area. The spatial relationship between the distribution of persons on anti-HIV therapy and the path of the monorail was assessed by digitizing the SkyTrain route over a digital Census Tract map. Statistical analyses were used to determine the characteristics of Census Tracts associated with the rate of anti-HIV medication use. The overall rate of anti-HIV medication use in the Census Tracts that are within 1Â km of SkyTrain was 66 per 100,000 population, whereas the rate was only 22 in the non-proximal Census Tracts. Multivariate analyses indicated that persons on anti-HIV therapy were significantly less likely to reside where there is a higher proportion of the population female, and were more likely to reside in areas with a higher proportion of the population of First Nations or Aboriginal descent, a higher population density, and in areas within 1Â km of the SkyTrain route. Our analyses suggest that neither migration, nor a heightened access to therapy explain these findings. The environment surrounding the SkyTrain may have been conducive to the spatial diffusion of HIV, and could be the focus of targeted public health interventions. The mechanisms responsible for the clustering of persons on anti-HIV medications around the SkyTrain require further investigation.

Suggested Citation

  • Wood, Evan & Chan, Keith & Montaner, Julio S. G. & Schechter, Martin T. & Tyndall, Mark & O'Shaughnessy, Michael V. & Hogg, Robert S., 2000. "The end of the line: has rapid transit contributed to the spatial diffusion of HIV in one of Canada's largest metropolitan areas?," Social Science & Medicine, Elsevier, vol. 51(5), pages 741-748, September.
  • Handle: RePEc:eee:socmed:v:51:y:2000:i:5:p:741-748
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    References listed on IDEAS

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    1. Deininger, Klaus & Squire, Lyn, 1996. "A New Data Set Measuring Income Inequality," World Bank Economic Review, World Bank Group, vol. 10(3), pages 565-591, September.
    2. Ettner, Susan L., 1996. "New evidence on the relationship between income and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 67-85, February.
    3. Godfrey, Leslie G & McAleer, Michael & McKenzie, Colin R, 1988. "Variable Addition and LaGrange Multiplier Tests for Linear and Logarithmic Regression Models," The Review of Economics and Statistics, MIT Press, vol. 70(3), pages 492-503, August.
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    Cited by:

    1. Frohlich, Katherine L. & Ross, Nancy & Richmond, Chantelle, 2006. "Health disparities in Canada today: Some evidence and a theoretical framework," Health Policy, Elsevier, vol. 79(2-3), pages 132-143, December.
    2. Roth, David & Otterstatter, Michael & Wong, Jason & Cook, Victoria & Johnston, James & Mak, Sunny, 2016. "Identification of spatial and cohort clustering of tuberculosis using surveillance data from British Columbia, Canada, 1990–2013," Social Science & Medicine, Elsevier, pages 214-222.
    3. Coldefy, Magali & Curtis, Sarah E., 2010. "The geography of institutional psychiatric care in France 1800-2000: Historical analysis of the spatial diffusion of specialised facilities for institutional care of mental illness," Social Science & Medicine, Elsevier, vol. 71(12), pages 2117-2129, December.

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