Using Geospatial Modeling to Identify HIV Treatment Opportunity Deserts in Sub-Saharan Africa

Speaker: Sally Blower
Director of the Center for Biomedical Modeling and Professor in the David Geffen School of Medicine at UCLA

The HIV pandemic is centered in sub-Saharan Africa (SSA), where ~25.5 million people live with HIV infection. UNAIDS has set treatment targets for ending the HIV pandemic by 2030: to diagnose 95% of people living with HIV infection (PLHIV), to treat 95% of the diagnosed, and to virally suppress 95% of the treated individuals. Elimination will ensue, because virally suppressed individuals cannot transmit the virus. Blower and her colleagues propose that—even when treatment coverage levels are high—due to the unequal geographic distribution of healthcare resources in SSA, HIV Treatment Opportunity Deserts may exist.

A treatment opportunity desert is an area where there is only a very low opportunity for a PLHIV to access antiretrovirals (ART). A desert could arise due to an exceptionally high demand for ART, a very low supply of ART, geographic inaccessibility of healthcare facilities that provide ART or any combination of these three factors. Due to the increased risk of HIV transmission in treatment deserts, they could function as barriers to HIV elimination.

In this talk, Blower will present a data-based framework that can be used to identify treatment opportunity deserts in any country in SSA. This framework will show that multiple treatment opportunity deserts existed in Malawi in 2021—even though the country was fairly close to achieving UNAIDS 2030 treatment targets. These results call into question the ability of UNAIDS treatment targets to eliminate the HIV pandemic.

This talk will be offered in person and over Zoom. Light refreshments will be served.

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Sally Blower is the Director of the Center for Biomedical Modeling and a Professor in the David Geffen School of Medicine at UCLA. Her group is currently using geospatial modeling to measure inequities in access to HIV care. They are developing a type of model that is new to infectious diseases—one focused on modeling the spatial provision of healthcare and enabling precise measurement of a community’s level of access to this resource. The modeling frameworks that they are developing could be applied in any sub-Saharan African country, and to infectious diseases other than HIV, e.g., tuberculosis and malaria.