The Origin and Diffusion of AIDS: A View from Medical Geography

Activity Space Mapping and Pre-Exposure Prophylaxis Uptake Among Gay, Bisexual, and Other Sexual Minority Men in Small Cities and Towns in the United States

In the US, gay, bisexual, and other sexual minoritized men (GBSMM) remain disproportionately impacted by HIV, and continue to experience unmet needs for pre-exposure prophylaxis (PrEP). A growing body of literature has underscored the need to consider the geographic factors of HIV prevention, particularly beyond administrative boundaries and towards localized spaces that influence the accessibility and utilization of health-promoting resources. Therefore, the purpose of this study is to examine the associations of driving times from activity spaces to PrEP offering facilities and individual PrEP uptake. A total of 218 GBSMM (ages 18-34) from Connecticut and Georgia were sampled from a longitudinal cohort study. We used the getis-ord-gi statistic to examine the spatial clustering of PrEP offering facilities, and generalized estimating equations (GEE) and post-hoc moderation analyses to explore the state interactions on driving time and PrEP uptake. Our main findings suggest that for participants in Connecticut, state of residence was a significant moderator on driving time and ever hearing of PrEP and ever taking PrEP. Whereas for participants in Georgia, state of residence moderated the likelihood of returning to activity spaces of participants in both Connecticut and Georgia on PrEP uptake. These findings provide important direction for geographic inequities on PrEP use, but also a pragmatic method for co-creating and re-imagining place-health research. These results also offer an avenue to leverage the dynamic nuance of activity spaces as indicators to inform structural interventions for PrEP that are more equitable for GBSMM in small cities and towns in the U.S.

Multidimensional Conditions of the First Wave of the COVID-19 Epidemic in the Trans-Industrial Region. An Example of the Silesian Voivodeship in Poland

The successive phases of the global COVID-19 pandemic show some differences from the first wave in 2020. The most important of these is some experience in responding to its spread and in applying vaccines. However, new, more aggressive variants of COVID-19 mean that the pandemic is often taking on the nature of the one experienced by societies a year ago. So, the knowledge about the first wave of the COVID-19 pandemic is still up-to-date—significantly where the essential determinants of its spread have not changed. The article presents the Silesian Voivodeship case in Southern Poland, distinguished by different geographical conditions compared to the entire country. The authors showed the relationship between the spread of the COVID-19 epidemic and the characteristic attributes of the analysed area (post-)mining functions or urban shrinkage. The article conducted a dependence study using the Pearson correlation coefficient and the signs table method. In turn, the authors used thematic cartography to present the results of the analysis. It turned out that two attributes, namely (post-)mining and urban shrinkage, are essential in spreading the epidemic with the region analysed. This conclusion may be essential in implementing national and regional policies related to reducing the COVID-19 pandemic. However, a limitation in the scope of the presented applications is the fact that mining regions, such as the Silesian (Śląskie) Voivodeship, are currently less numerous in the world than, for example, those that develop based on services.

Health, sexuality and place: the different geographies of HIV-positive gay men in Auckland, New Zealand

This paper employs interview narratives alongside participant-led photography and caption writing to examine the different daily geographies of 15 HIV-positive gay men in Auckland, New Zealand. Difference for these men is rooted in both their HIV status and their sexuality, and this difference has implications for their engagement with the world at a range of spatial and temporal scales. Giving voice to such experiences begins to answer calls for geographers to consider more deeply the connections between health, sexuality and place.

Geography, ecology and emerging infectious diseases

Emerging infectious diseases are the focus of increased attention and even alarm in the scholarly and popular literature. The emergence of new diseases and the resurgence of older and previously recognized infectious diseases both in developing and developed country poses challenges for understanding the ecological web of causation, including social, economic, environmental and biological components. This paper is a synthesis of the major characteristics of emerging diseases, in an interdisciplinary context. Political ecology is one framework for analysis that is promising in developing a modified ecology of disease.

Casey House: interpreting the location of a Toronto AIDS hospice

This paper focuses on an overtly geographical issue, the introduction of a housing facility for people living with AIDS (PLWAs) into the urban landscape. Specifically, we critically analyze the location of Casey House, an AIDS hospice in Toronto and presently the only facility of its kind in Canada. Three questions are addressed: (i) how did Casey House come to exist?; (ii) why is Casey House located at the corner of Huntly Street and Isabella Street?; and (iii) will Casey House be reproduced? In our response to the first two questions, we draw selectively upon three perspectives (accessibility, structuralist and humanistic) that have been appealed to in analyses of (controversial) health care facility location processes. In the concluding discussion, three relevant spheres of reproduction are considered: locational, institutional and social. In consideration of the obvious constraints on reproduction, we conclude that the creation and location of Casey House may well be a unique geographical event in Canada.

Growth models and the HIV epidemic in Finland

Today, we know a lot about HIV and AIDS, yet too little to be able to stop the pandemic by a vaccination or by medication. Until that day is at hand, the only means of controlling the pandemic is by information--information about the diffusion of the virus, about risk behaviour, about safe sex, and about social responsibility. Educating people must be based on concise clinical experience, an up-to-date picture of the epidemiological situation, and reliable forecasts about the future course of the epidemic. Producing reliable forecasts about the HIV epidemic has proved to be a more complicated task than expected. The proven, reliable, and in most cases very useful epidemiological models have been far from successful when applied to the HIV epidemic. The reason for this is mostly due to the lack of reliable data depicting the true HIV seroprevalence. Instead of being handicapped by the problems of inadequate data, geographical modelling of the HIV epidemic is able to rely on its theoretical understanding and good knowledge about the spatial organization and the functioning of societies to make is forecasts. Due to its flexibility of approach, geographical modelling can adjust itself to less accurate data, thus providing an interim forecasting instrument until epidemiological modelling becomes successful. This paper presents the results of an analysis of the HIV epidemic in Finland based on cartographic analysis of municipal data and the use of a simple growth model.