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Jeffrey B. Bingenheimer, MPH, School of Public Health, University of Michigan, 1420 Washington Heights, Ann Arbor, MI 48109, 734-213-5949, bartbing@umich.edu
Background. The AIDS pandemic has followed different trajectories in different regions of the world. At the local level, however, the degree of heterogeneity in the trajectories of AIDS epidemics is unknown. One reason for this is that the small number of cases occurring annually in some populations makes local trajectories difficult to characterize with precision. Methods. We estimated temporal trajectories of AIDS mortality for each of 340 neighborhoods in Chicago, Illinois, for 1985-2002. Using census data and geocoded death certificates, we computed annual AIDS mortality rates for each neighborhood. Within each neighborhood, we modeled the log of the AIDS mortality rate as a polynomial function of time. In order to stabilize estimates of the polynomial coefficients, we used a multilevel model to obtain empirical Bayes or “shrinkage” estimators. Preliminary Results. Hypothesis tests for the variance components of the multilevel model suggest that trajectories vary measurably between neighborhoods. Several of the implied neighborhood-specific AIDS mortality trajectories are plotted, along with the average trajectory, to illustrate their heterogeneity. Conclusions. Heterogeneity in the trajectories of AIDS epidemics found at the neighborhood level suggests that some of the social processes fueling the spread of HIV-1 may be local in nature.
Learning Objectives: At the conclusion of the session, the participant will be able to
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.