Geographic area-based rate as a novel indicator to enhance research and precision intervention for more effective HIV/AIDS control

Ending the HIV epidemic needs additional methods to better assess the incidence and prevalence of HIV infection. In this study, a new indicator — G-rate was developed for the evaluation of HIV epidemics across regions with regard to geographic area size. Different from the commonly used incidence and prevalence rates that assess the HIV epidemic with reference to population (termed as P rate in this study), G rate measures the number of new infections (incidence) or cases (prevalence) over a unit land area in one year. We demonstrated the utility of G rates using officially reported data on new HIV infections and persons living with HIV in the United States during 2000–2012. Findings of our analysis indicate that relative to P rates, G rates indicated a quicker increase in the HIV epidemic in the United States during the study period. In 2012, 4.6 persons were newly infected and 101.4 persons lived with HIV per 1000 km(2) land area. The five states with both highest P prevalence rates and highest G prevalence rates were Florida, Maryland, New York, New Jersey and Washington DC, which included New Jersey ranked 8th by P rate and excluded Massachusetts ranked 5th by G rate. In conclusion, adding G rates extends the conventional measurement system that consists of case count and P rate. Combining G rates with P rates provides a new approach for information extraction to support precision intervention strategy toward the goal of creating an AIDS-Free Generation.