Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Aug 19, 2024
Date Accepted: Mar 4, 2025
Behavioral and demographic profiles of HIV Transmission and Exposure Networks in Florida: A Network Analysis of HIV Contact Tracing Data
ABSTRACT
Introduction: To complete the Ending the HIV Epidemic initiative in areas with high HIV incidence, there needs to be a greater understanding of the demographic, behavioral, and geographic factors that influence the rate of new HIV diagnoses. This information will aid the creation of targeted prevention and intervention efforts. The aim of this study is to identify the geographic distribution of risk groups and their role within potential transmission networks in Florida.
Methods:
Public data from the Florida Department of Health and behavioral data from the Surveillance Tools and Reporting System (STARS) between 2012-2022 were used in these analyses. We analyzed records as a combination of variables of interest (gender, age, race/ethnicity, and HIV risk group) in order to create demographic-behavioral profiles (DBPs) that represent the profiles of newly-diagnosed people with HIV. We then used the resulting DBPs to characterize Florida counties and HIV Coordination Areas and calculated the county-to-county and area-to-area rank (Spearman) correlation. We then drew a dendrogram based on the correlation matrix and identified clusters of similar counties and areas.
Results:
We identified 37 DBPs. The largest DBPs were Hispanic and non-Hispanic Black males aged 25-49 reporting male-to-male sexual contact (MMSC), non-Hispanic White males aged 25-49 reporting MMSC, and non-Hispanic Black females aged 25-49 reporting heterosexual contact. The state could be broken up generally into two transmission clusters by region: Northwestern/Northern and Central/Southern. We identified several counties with similar DBPs that were not in the same HIV Coordination Area. Conclusion: We identified distinct risk groups and clusters of transmission throughout Florida. These results can help regions identify health disparities and allocate their HIV prevention and intervention resources accordingly. The goal of this work was to highlight areas of need in a high incidence setting, not contribute to existing stigma against vulnerable groups, and it is important to consider the ethics and possible harm of advanced methodologies such as contact network analysis when addressing public health problems.
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