Visualizing the geography of HIV observational cohorts with density-adjusted cartograms
AUTHORS
- PMID: 34974471 [PubMed].
ABSTRACT
BACKGROUND: Maps are potent tools for describing the spatial distribution of population and disease characteristics, and thereby, for appropriately targeting public health interventions. People with HIV (PWH) cluster in geographically compact and densely populated areas, which does not easily lend itself to maps that use unadjusted geographic or political borders.
SETTING: To illustrate these challenges, we used geographic data from adult PWH at the Vanderbilt Comprehensive Care Clinic (VCCC), in Nashville, Tennessee, and aggregated data from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) from 1998-2015.
METHODS: We compared choropleth maps, which use differential shading of political/geographic boundaries, and density-adjusted cartograms, which allow for shading and deformed boundaries according to a variable of interest, such as PWH.
RESULTS: Cartograms enlarged high-burden areas and shrank low-burden areas of PWH, improving visual interpretation of where to focus HIV prevention and mitigation efforts compared to choropleth maps. Cartograms may also demonstrate cohort representativeness of underlying populations (e.g., Tennessee for VCCC or the United States for NA-ACCORD), which can guide efforts to assess external validity and improve generalizability.
CONCLUSION: Choropleth maps and cartograms offer powerful visual evidence of the geographic distribution of HIV disease and cohort representation and should be used to guide targeted public health interventions.
Tags: alumni publications 2021