According to a new study published this week in the open-access journal PLOS Global Public Health by Diego Cuadros of the University of Cincinnati and colleagues, 7 million people living with HIV in Sub-Saharan Africa live more than 10 minutes away from health care services, and 1.5 million people living with HIV live more than 60 minutes away from a healthcare facility.
For decades, HIV/AIDS has been a prominent cause of morbidity and mortality in parts of Africa. Despite efforts to raise the proportion of people diagnosed with HIV who receive antiretroviral medication (ART), in 2019, between a quarter and half of all HIV patients in Africa did not receive ART, depending on the location. To improve these figures and fulfill global targets for HIV treatment rates, geographical barriers must be removed and access to health facilities must be improved.
Researchers looked at data on the number of people living with HIV in 47 African nations, population distribution within these countries, and healthcare facility locations in the new study. They were able to figure out how far HIV patients live from care, using either motorized transportation or walking alone, for every 5-kilometer square by integrating this data.
According to the map, 90.5 percent of the total geographical area assessed was more than 10 minutes away from the nearest healthcare facility, with 7 million people living with HIV (35 percent of HIV patients) in this area. 74.6 percent of the land area was more than 30 minutes away from healthcare (with 3 million people living with HIV accounting for 15.6 percent of patients), and 58.9% of the land area was more than 60 minutes away (containing 1.5 million people with HIV, 7.6 percent ). The figures varied per country, with only 1.6 percent of Swaziland’s population living within 60 minutes of healthcare, compared to more than 90 percent in Sudan and Mauritania. When walking time was used instead of motorized transportation time, the results were likewise different; 33.0 percent of HIV-positive people (or 6.6 million people) resided more than a 60-minute walk from the nearest healthcare center.
The findings and new map, according to the authors, can help establish cost-effective policies for HIV interventions in underprivileged areas. Alternatives to improved accessibility, such as varied service delivery or mobile outreach for HIV services, could be offered for places where people are far from healthcare facilities.
The authors continue: “Unequal access to healthcare facilities and structural inequality are just some of the systemic hurdles many communities face. This issue is deeper in regions suffering a generalized HIV epidemic like Africa, where more than 1.5 million people living with HIV are located in underserved rural communities”
Kim, H., et al. (2021) When distance matters: Mapping HIV health care underserved communities in sub-Saharan Africa. PLoS Global Public Health.