Women with HIV/AIDS in New York City - A Geographic Review
Women with HIV/AIDS in New York City A Geographic Review Women’s HIV Collaborative of New York with The Justice Mapping Center <ul><li>Data Sources </li></ul><ul><li>NYC Department of Health and Mental Hygiene, HIV Epidemiology & Field Services Program (2007) </li></ul><ul><li>New York City Department of Education (2007) </li></ul><ul><li>Voices of Women of Color Against HIV/AIDS (2007) </li></ul><ul><li>New York State Division of Criminal Justice Services (2003) </li></ul><ul><li>United States Census Bureau (2000) </li></ul>
Background <ul><li>The Women’s HIV Collaborative of New York created a Women and Girls HIV/AIDS Visibility Plan to: </li></ul><ul><li>recognize, explore and address the impact the epidemic is having on women and girls in this City, </li></ul><ul><li>and to determine mechanisms for improving prevention and care coordination for women’s HIV programming. </li></ul>
Background As part of that plan the Collaborative conducted a community mapping project of NYC and honed in on those areas in NYC where women are most highly impacted by the HIV/AIDS epidemic, and have been able to illustrate how high HIV incidence rates correlate with other significant co-factors such as poverty, incarceration, lack of access to health care, and sexual and reproductive health.
This map shows the regions in New York City where the highest number of people living with HIV/AIDS reside. Zip Codes with at least 1,000 residents living with HIV/AIDS are concentrated in four major regions around the City: <ul><li>Interior of the Bronx </li></ul><ul><li>Harlem </li></ul><ul><li>The Lower East and West sides </li></ul><ul><li>Central Brooklyn </li></ul>
Although it is important to know where the highest number of people living with HIV/AIDS are, it is at least as critical to know where the highest rates are, because the places with the highest number of people living with HIV/AIDS may simply be the places with the most people overall. So to see where the problem is highly concentrated, we have to look at a rate map like this one. Zip Codes with a rate of at least 25 residents per 1000 living with HIV/AIDS are concentrated in the interior Bronx, Harlem, and the Lower West Side.
When we separate our map of the rate of people living with HIV/AIDS into two between men and women, we see that the highest rates for each are concentrated in different places. Men are most highly concentrated in the Lower West Side, and less so in parts of Harlem and some of the Bronx interior. While women are more highly concentrated in the South and Central Bronx, and less so in Harlem, and parts of Central Brooklyn.
Unlike men, the highest concentration of women living with HIV/AIDS falls almost entirely within the highest poverty neighborhoods in the City.
Similarly, the highest concentration of women living with HIV/AIDS also falls almost entirely within the highest incarceration rate neighborhoods in the City.
Women living with other sexually transmitted diseases are highly concentrated in the same areas as women living with HIV/AIDS and represent an echo of the same conditions of poverty and incarceration that predominate in these neighborhoods. Together, these maps suggest that the highest rates of women living with HIV/AIDS might be more related to behavior associated with neighborhood conditions of distress, than with behavior associated with sexual orientation as might be more related to men in the City.
New York City Youth Risk Behavior Survey (YRSB) provides other community indicators of HIV and Sex related risk <ul><li>Overall, nearly 1 in 5 sexually active females (19%) did not use birth control the last time they had sex, compared to 14% nationwide. </li></ul><ul><li>Among three areas in NYC with persistently high teen pregnancy rates (South Bronx, East and Central Harlem, and North and Central Brooklyn), females in the South Bronx (26%) are most likely to report having sex without birth control. </li></ul>
As pertains to women living with HIV/AIDS, when we combine both geographical factors—highest number and highest rates—we can identify neighborhood areas (outlined in yellow) whose residents are most in need of support and where service investments would reap the highest returns on public health.
When we hone in on a more detailed view of Brooklyn, we can more precisely identify those zip code areas with the combined highest number and highest rate of women living with HIV/AIDS. The large cluster of service centers in downtown Brooklyn reflects its role as a hub of other social services. Most of the women living with HIV/AIDS are between 40 – 49. Of the foreign born women in Brooklyn diagnosed with HIV between 2001 – 2006, most are from the Caribbean/West Indies
These geographical findings suggest that there may be ways to improve services for women living with HIV/AIDS, including: <ul><li>Developing self-help, group support, and information networks among women in the neighborhoods. </li></ul><ul><li>Strengthening the capacity of women in the target neighborhoods to identify service priorities and to advocate effectively for their implementation. </li></ul><ul><li>Exploring neighborhood based street outreach. </li></ul><ul><li>Reviewing the extent to which services in targeted neighborhoods are particularly aware of the needs specific to women. </li></ul><ul><li>Tailoring services to take account of neighborhood conditions such as poverty and cyclical migration between prison and community. </li></ul>