Targeting the right interventions to the right people and places: the role of geospatial analysis in HIV program planning

Abstract

Geospatial epidemiology has a long history. From Snow's famous investigation of the 1854 cholera outbreak in London to today, observing diseases in relation to people, place, and time has been essential for understanding and responding to epidemics. In 2016, the response to HIV/AIDS sustained more than 17 million people worldwide on lifesaving antiretroviral treatment. Yet in the current era of falling donor support and with governments of low-income countries needing to balance many spending priorities, it is vital to maximize the impact and efficiency of the AIDS response. National and international stakeholders have increasingly supported geospatial targeting of resources as a means to accomplish this, and the challenge for program designers has become how best to link the 'who' and 'where' with the 'what' and 'when'. However, a key question is whether geospatial efforts ultimately translate into more effective interventions to reduce HIV incidence. We contend here that geospatial analysis has indeed delivered some successes thus far, but that the gap between academic studies and the needs of policy-setters must be narrowed if its full potential is to be realized.