The Influence of Spatial Structure on Disease Transmission,
Prevalence and Treatment

• Peter Gould – Spatial Diffusion Theory and
AIDS
• The Slow Plague criticized traditional epidemiology for ignoring the spatial dimensions of aids
• In part due to it’s popular writing style, it’s overtly political stance and it’s “geographic elitism” Gould’s work was received with mixed reviews.

Preface: Why a geographer writes about AIDS.
Acknowledgements: Intellectual Antennae.
Prologue: New Plagues for Old: The Horseman Rides Again.
1. The Killer: HIV and What it does.
2. The Origins of HIV: Closing an Open Question?
3. The Thin Tendrils of Effects.
4. Sex on a Set: A Backcloth for Disaster.
5. Transmission Break: The Geography of the Condom.
6. How Things Spread: Hierarchical Jumps and Geographic Oozings.
7. Africa: A Continent in Catastrophe.
8. Thailand: How to Optimize an Epidemic.
9. America: Leaks in the System.
10. The Bronx: Poverty, Crack and HIV.
11. The Response: How Many Bureaucrats can Dance on the Head of a Pin?
12. Time but no Space: the Failure of a Paradigm.
13. The Geography in Confidentiality.
14. Education and Planning: Predicting the Next Maps.
15. Herd Immunity: Riding the Coattails of the HIV.
16. Epilogue: Old Plagues for New.
AIDS: A Bibliographic Essay.
Index.

• The spatial epidemiology of AIDS is still important however, other uses of spatial data within HIV/AIDS research are emerging
• Accessibility of AIDS related treatment and services
• Contextual factors associated with treatment adherence
• Stigma related geographies

• Geographic Information Science = theory
• Geographic Information Systems = tool
• Geographic data comes in many forms and often requires tedious conversion with specialized software tools
• Geographic theory drives the analytical process, including geostatistics

• Two main types – Raster and Vector
• Raster is pixel based (cells, resolution)
• Vector is Cartesian Coordinate based (x-y points, lines, lengths, polygons, areas, perimeters.
• GIS systems integrate the two types and store data and information as “geographic features” referenced to real world coordinate systems.

• Geographic disparities in AIDS mortality rates (Robinson)
• HIV testing center locations and risky sexual behavior (Taylor)
• Spatial reach of AIDS interventions (Kim)

• Although there has been history of interaction, in general the integration of geographic theory and methods within
AIDS research has remained minimal.
• The importance of this integration is clear to funding agencies, and there are many research opportunities available, especially for collaborations with clear interdisciplinary contributions.