HIV testing day is June 27. On this day, organizations throughout the U.S. sponsor a wide variety of events, including free testing and education.  As HRSA’s Health Center Program funds 10,000 health center sites, serving over 24 million people, it is uniquely situated to address the HIV crisis. In fact, the health center program focuses on care for underserved and vulnerable populations, the same populations disproportionately affected by HIV.  One way the health center program is leveraging this is by participating in the Department of Human Services’ “Ending the Epidemic: A Plan for America.” This new 10-year initiative aims to virtually eliminate new HIV infections in the U.S. by focusing on early diagnosis, rapid treatment, proven prevention, and rapid outbreak response among areas most at risk. When the initiative begins next year, health centers in target areas will expand outreach as well as both routine and risk-based HIV testing opportunities.

As a geographer, I was curious about the communities targeted by the Ending the Epidemic initiative and the health centers located within them. I wanted to visualize the service areas of these health centers in relation to other community resources and overlay some population health data. To get started, I created a series of maps of Franklin County, Ohio, one of the initiative’s 48 target counties, using the UDS Mapper.

The UDS Mapper is ideal for this type of project as it is an online mapping and decision-support tool driven primarily by patient location data within the Uniform Data System (UDS). It allows easy visualization of health center service areas, along with patient data, population health data, and health related facilities. Within the UDS Mapper, I started by navigating to Franklin County, Ohio, then activating the By Patient Origin mode of the Explore Service Area tool.

UDS Mapper with Explore Service Area tool set to By Patient Origin mode

I could see right away that there are five organizations located within Franklin County. I wanted to see how large their service areas are and where they overlap.

I clicked on each organization which added its core, in this case 75%, patient origin service area to the map. I could see that these organizations serve many Franklin County ZIP Code Tabulation Areas (ZCTAs), especially those in and adjacent to the city of Columbus.
Patient origin service areas


I turned on service access points and saw that they are also mostly concentrated in central Franklin County.
Patient origin service areas with health center service access points
For demonstration purposes, I chose Columbus Neighborhood Health Center (CNHC) to examine further. I de-selected the other health centers so my map only showed CNHC’s patient origin service area, then I opened the Data Table. Studies show that people with health insurance have greater access to HIV testing, and that early knowledge of one’s HIV status reduces HIV-related morbidity and mortality and reduces the risk of transmission (KFF, 2019). To assess population insurance status and access to care for CNHC’s service area, I added uninsurance and no usual source of care data to my table. I could see at a glance that in the ZCTAs that comprise CNHC’s core service area, 9% of the population are uninsured and 19% have no usual source of care.
Data table and summary row

I then used the Population Indicators tool to see which ZCTAs are at or above these service area benchmarks.

ZCTAs with relatively high rates of uninsurance and no usual source of care

Twelve ZCTAs within the health center’s service area have uninsured rates above 9% and more than 19% of the population without a usual source of care. These ZCTAs might be ideal areas in which to focus the initiative’s early outreach efforts.
I also wanted to see what other health resources are nearby. There are four opioid treatment programs which could serve as ideal partners throughout the initiative. This is important as intravenous drug use is a major risk factor for HIV transmission, and drug use in persons with HIV could exacerbate the progression of the virus (NIDA, 2018). Additionally, there are several hospitals and public housing facilities within CNHC’s service area which could serve as potential HIV care collaborators.
Health centers, hospitals and public housing sites added to map


Using the UDS Mapper, I was able to quickly and effectively visualize population health and resource data for a health center located within an Ending the Epidemic target county. If you’re interested in trying the UDS Mapper, go to www.udsmapper.org, and don’t miss the Tutorials page for details on each of the tools I used and more. And finally, take advantage of National HIV Testing Day – attend a HRSA webinar, read up on the CDC website, get tested, or just spread the word using the #DoingItMyWay hashtag on social.

Jessica McCann
User Engagement Specialist, HealthLandscape


References
KFF. June 25, 2019. HIV Testing in the United States


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