Spatial accessibility and the spread of HIV-1 subtypes and recombinants

Tatem, A.J., Hemelaar, J., Gray, R.R. and Salemi, M. (2012) Spatial accessibility and the spread of HIV-1 subtypes and recombinants AIDS, 26, (18), pp. 2351-2360. (doi:10.1097/QAD.0b013e328359a904). (PMID:22951637).


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OBJECTIVE/DESIGN: The global spread of HIV-1 group M has resulted in differential distributions of subtypes and recombinants, with the greatest diversity being found in sub-Saharan Africa. The explanations for the current subtype distribution patterns are likely multifactorial, but the promotion of human migrations and movements through transportation link availability and quality, summarised through 'accessibility', have been consistently cited as strong drivers. We sought to address the question of whether accessibility has been a significant factor in HIV-1 spread across mainland Africa through spatial analyses of molecular epidemiology, transport network and land cover data.

METHODS: The distribution of HIV-1 subtypes and recombinants in sub-Saharan Africa for the period 1998-2008 was mapped using molecular epidemiology data at a finer level of detail than ever before. Moreover, hypotheses on the role of distance, road network structure and accessibility in explaining the patterns seen were tested using spatial datasets representing African transport infrastructure, land cover and an accessibility model of landscape travel speed.

RESULTS: Coherent spatial patterns in HIV-1 subtype distributions across the continent exist, and a substantial proportion of the variance in the distribution and diversity patterns seen can be explained by variations in regional spatial accessibility.

CONCLUSIONS: The study confirms quantitatively the influence of transport infrastructure on HIV-1 spread within Africa, presents an approach for examining potential future impacts of road development projects and more generally, highlights the importance of accessibility in the spread of communicable diseases.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1097/QAD.0b013e328359a904

Organisations: Geography & Environment
ePrint ID: 344467
Date :
Date Event
28 November 2012Published
Date Deposited: 29 Oct 2012 11:58
Last Modified: 17 Apr 2017 16:27
Further Information:Google Scholar

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