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Judith Sackoff - One of the best experts on this subject based on the ideXlab platform.
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concurrent hiv AIDS Diagnosis increases the risk of short term hiv related death among persons newly diagnosed with AIDS 2002 2005
Aids Patient Care and Stds, 2008Co-Authors: David B. Hanna, Melissa R. Pfeiffer, Lucia V. Torian, Judith SackoffAbstract:Despite the overall effectiveness and availability of highly active antiretroviral therapy (HAART), 1500 HIV-related deaths still occur annually in New York City. In considering ways to further reduce deaths, we assessed the contribution of concurrent HIV/AIDS Diagnosis to HIV-related mortality in New York City among persons newly diagnosed with AIDS. We used Cox regression to conduct a retrospective cohort analysis of HIV-related mortality among 15,211 residents age 13+ reported with AIDS to the population-based HIV/AIDS registry between January 2002 and June 2005. Concurrent HIV/AIDS Diagnosis was defined as a Diagnosis of AIDS occurring within 1 month of initial Diagnosis of HIV. HIV-related mortality was 20.2% among persons diagnosed concurrently and 12.2% among those diagnosed nonconcurrently (p < 0.0001). Concurrent HIV/AIDS was associated with more than twice the risk of HIV-related death within the 4 months after Diagnosis (hazard ratio [HR] 2.27, 95% confidence interval [CI] 1.94–2.65) but no inc...
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Concurrent HIV/AIDS Diagnosis increases the risk of short-term HIV-related death among persons newly diagnosed with AIDS, 2002-2005.
AIDS patient care and STDs, 2008Co-Authors: David B. Hanna, Melissa R. Pfeiffer, Lucia V. Torian, Judith SackoffAbstract:Despite the overall effectiveness and availability of highly active antiretroviral therapy (HAART), 1500 HIV-related deaths still occur annually in New York City. In considering ways to further reduce deaths, we assessed the contribution of concurrent HIV/AIDS Diagnosis to HIV-related mortality in New York City among persons newly diagnosed with AIDS. We used Cox regression to conduct a retrospective cohort analysis of HIV-related mortality among 15,211 residents age 13+ reported with AIDS to the population-based HIV/AIDS registry between January 2002 and June 2005. Concurrent HIV/AIDS Diagnosis was defined as a Diagnosis of AIDS occurring within 1 month of initial Diagnosis of HIV. HIV-related mortality was 20.2% among persons diagnosed concurrently and 12.2% among those diagnosed nonconcurrently (p < 0.0001). Concurrent HIV/AIDS was associated with more than twice the risk of HIV-related death within the 4 months after Diagnosis (hazard ratio [HR] 2.27, 95% confidence interval [CI] 1.94–2.65) but no inc...
Jens D. Lundgren - One of the best experts on this subject based on the ideXlab platform.
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HIV-related non-Hodgkin's lymphoma among European AIDS patients. AIDS in Europe Study Group. AIDS in Europe Study Group
European journal of haematology, 2009Co-Authors: Court Pedersen, Christine Katlama, Antonio Chiesi, Anne M Johnson, S. E. Barton, Peter Skinhøj, J. Van Lunzen, Bernard Hirschel, S. Maayan, Jens D. LundgrenAbstract:The epidemiology of HIV associated non-Hodgkin's lymphoma (NHL) was investigated in 6550 European patients with AIDS. NHL was diagnosed in 3.5% of all patients at the time of the AIDS Diagnosis. Although the probability of being diagnosed with NHL at AIDS Diagnosis was significantly higher among intravenous drug users than among homosexual men, and was associated with increasing age, the observed incidences of NHL were more strikingly similar than any differences. The rate of developing NHL after a previous AIDS Diagnosis was 2.4 per 100 patient years of follow-up, and remained constant during a 5-year follow-up period. While primary brain lymphomas comprised only 9% of NHL diagnosed at the time of AIDS, they comprised 38% of NHL diagnosed after AIDS (p < 0.001). The prognosis for patients with NHL at AIDS Diagnosis was poor with a median survival of 5 months. A Diagnosis of primary brain lymphoma was uniformly associated with a poor outcome. It is concluded that the probability of developing NHL in late stage HIV infection is lower than previously anticipated from the results of small studies on patients receiving long-term anti-retroviral therapy.
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Influence of Age on Rates of New AIDS-defining Diseases and Survival in 6546 AIDS Patients
Scandinavian journal of infectious diseases, 1997Co-Authors: Ulla Balslev, Court Pedersen, Andrew N. Phillips, Antonella D'arminio Monforte, George S. Stergiou, F Antunes, Fiona Mulcahy, Per Olav Pehrson, Jens D. LundgrenAbstract:It has consistently been reported that older AIDS patients have a shortened survival compared with younger patients. The aim of the present study was to investigate whether this difference in survival is caused by differences in the pattern of the complicating diseases. Information on patient follow-up after the AIDS Diagnosis was obtained by retrospective case note review. The 6,546 patients were followed from the time of AIDS Diagnosis as part of the multicentre AIDS in Europe study, which examined AIDS cases diagnosed at 52 centres in 17 European countries between 1979 and 1989. Occurrence of AIDS-defining events and demographic variables were recorded for all patients, and CD4 lymphocyte count at the time of AIDS Diagnosis for approximately half the patients. After adjusting for imbalances in other variables, persons ≥50 years of age had a significantly higher risk of contracting AIDS wasting syndrome, AIDS dementia complex and oesophageal candidiasis after the initial AIDS Diagnosis, compared with ag...
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Epidemiology of cryptosporidiosis among European AIDS patients.
Sexually Transmitted Infections, 1996Co-Authors: Court Pedersen, Sven A. Danner, Adriano Lazzarin, Michel P. Glauser, Rainer Weber, Christine Katlama, S. Barton, Jens D. LundgrenAbstract:OBJECTIVE: To study epidemiology and possible risk factors associated with the development of cryptosporidiosis among European patients with AIDS. METHODS: An inception cohort of 6548 patients with AIDS, consecutively diagnosed from 1979 to 1989, from 52 centres in 17 European countries was studied. Data on all AIDS defining events were collected retrospectively from patients9 clinical records. Kaplan-Meier estimates, log rank tests and Cox proportional hazard models were used to examine for possible risk factors associated with cryptosporidiosis. RESULTS: Cryptosporidiosis was diagnosed in 432 (6.6%) patients, 216 at time of the AIDS Diagnosis and 216 during follow-up. The probability of being diagnosed with cryptosporidiosis at AIDS Diagnosis was significantly lower for intravenous drug users (1.3%) than for homosexual men (4.1%) and for patients belonging to other transmission categories (4.0%) (p
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Factors Associated with the CD4' Lymphocyte Count at Diagnosis of Acquired Immunodeficiency Syndrome
Journal of clinical epidemiology, 1996Co-Authors: Andrew N. Phillips, Jens D. Lundgren, Court Pedersen, Adriano Lazzarin, Michel P. Glauser, Juan Gonzales-lahoz, Nathan Clumeck, Rui Proenca, Dénes Bánhegyi, Anne M JohnsonAbstract:To assess which factors are associated with the CD4+ lymphocyte count at the time of AIDS Diagnosis we studied 3046 patients in the AIDS IN EUROPE study who were diagnosed with AIDS in 1 of 17 European countries between 1979 and 1989 and for whom the CD4 count at AIDS Diagnosis was known. Data were extracted retrospectively from patient case notes, using a standardized form. There was a wide range of average CD4+ lymphocyte counts at AIDS Diagnosis, according to which diseases were present at Diagnosis. The highest geometric mean CD4+ lymphocyte counts at AIDS Diagnosis were associated with the Diagnosis of extrapulmonary tuberculosis, Kaposi's sarcoma, and non-Hodgkin's lymphoma while the lowest counts were found when histoplasmosis and cytomegalovirus (CMV) retinitis were present. There were no appreciable differences between CD4+ lymphocyte counts at AIDS in patients according to the three major transmission route categories (sex, age, or region of Diagnosis) but there was a marked trend (p < 0.005) toward lower CD4+ lymphocyte counts at AIDS Diagnosis in more recent years. These associations remained largely unchanged after adjustment for other factors.
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Epidemiology of AIDS-related Kaposi's sarcoma in Europe over 10 years
AIDS (London England), 1996Co-Authors: Philippe Hermans, Jens D. Lundgren, Court Pedersen, Christine Katlama, Anthony J. Pinching, Bernadette Sommereijns, Stephano Vella, Ruedi Lüthy, Jan Gerstoft, P. O. PehrsonAbstract:Objectives : To determine the incidence and risk factors associated with Kaposi's sarcoma (KS) occurrence as an AIDS-defining condition or after the Diagnosis of AIDS. Design : Multicentre retrospective cohort study of AIDS in Europe database from 52 clinical centres in 17 European countries. Methods : Patients' charts (n = 6546) were reviewed and collected in the database of the AIDS in Europe Study Group from 1979 to 1989. At the time of AIDS Diagnosis 1394 patients had KS, whereas an additional 525 others developed KS after AIDS Diagnosis. Univariate analysis and development of multivariate models determined factors associated with KS occurrence. Results : Frequency of KS as an AIDS-defining condition significantly declined over time (P 150 x 10 6 /l were statistically more likely to develop KS at the time of AIDS Diagnosis (P< 0.0001). For patients with an AIDS Diagnosis other than KS, the probability of developing KS during the follow-up was 10 and 24% after 12 and 36 months, respectively. Variables significantly associated with a further KS development were transmission group, central European residence, previous herpes simplex infection other than ulcers, and low CD4 cells (< 150 x 10 6 /l). Previous zidovudine therapy had no influence on KS appearance. For patients who developed KS subsequent to AIDS Diagnosis, there was no significant decline of the incidence over the 10-year time period. Conclusions : This large cohort study clearly shows that demographic data such as sex, transmission group and region of Europe have a major influence on KS development. It also suggests that KS as an AIDS-defining disease occurs earlier in the course of the chronic HIV infection than other opportunistic diseases. Reasons for geographical variations and its declining frequency as an initial AIDS Diagnosis remain undetermined.
David B. Hanna - One of the best experts on this subject based on the ideXlab platform.
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concurrent hiv AIDS Diagnosis increases the risk of short term hiv related death among persons newly diagnosed with AIDS 2002 2005
Aids Patient Care and Stds, 2008Co-Authors: David B. Hanna, Melissa R. Pfeiffer, Lucia V. Torian, Judith SackoffAbstract:Despite the overall effectiveness and availability of highly active antiretroviral therapy (HAART), 1500 HIV-related deaths still occur annually in New York City. In considering ways to further reduce deaths, we assessed the contribution of concurrent HIV/AIDS Diagnosis to HIV-related mortality in New York City among persons newly diagnosed with AIDS. We used Cox regression to conduct a retrospective cohort analysis of HIV-related mortality among 15,211 residents age 13+ reported with AIDS to the population-based HIV/AIDS registry between January 2002 and June 2005. Concurrent HIV/AIDS Diagnosis was defined as a Diagnosis of AIDS occurring within 1 month of initial Diagnosis of HIV. HIV-related mortality was 20.2% among persons diagnosed concurrently and 12.2% among those diagnosed nonconcurrently (p < 0.0001). Concurrent HIV/AIDS was associated with more than twice the risk of HIV-related death within the 4 months after Diagnosis (hazard ratio [HR] 2.27, 95% confidence interval [CI] 1.94–2.65) but no inc...
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Concurrent HIV/AIDS Diagnosis increases the risk of short-term HIV-related death among persons newly diagnosed with AIDS, 2002-2005.
AIDS patient care and STDs, 2008Co-Authors: David B. Hanna, Melissa R. Pfeiffer, Lucia V. Torian, Judith SackoffAbstract:Despite the overall effectiveness and availability of highly active antiretroviral therapy (HAART), 1500 HIV-related deaths still occur annually in New York City. In considering ways to further reduce deaths, we assessed the contribution of concurrent HIV/AIDS Diagnosis to HIV-related mortality in New York City among persons newly diagnosed with AIDS. We used Cox regression to conduct a retrospective cohort analysis of HIV-related mortality among 15,211 residents age 13+ reported with AIDS to the population-based HIV/AIDS registry between January 2002 and June 2005. Concurrent HIV/AIDS Diagnosis was defined as a Diagnosis of AIDS occurring within 1 month of initial Diagnosis of HIV. HIV-related mortality was 20.2% among persons diagnosed concurrently and 12.2% among those diagnosed nonconcurrently (p < 0.0001). Concurrent HIV/AIDS was associated with more than twice the risk of HIV-related death within the 4 months after Diagnosis (hazard ratio [HR] 2.27, 95% confidence interval [CI] 1.94–2.65) but no inc...
Court Pedersen - One of the best experts on this subject based on the ideXlab platform.
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HIV-related non-Hodgkin's lymphoma among European AIDS patients. AIDS in Europe Study Group. AIDS in Europe Study Group
European journal of haematology, 2009Co-Authors: Court Pedersen, Christine Katlama, Antonio Chiesi, Anne M Johnson, S. E. Barton, Peter Skinhøj, J. Van Lunzen, Bernard Hirschel, S. Maayan, Jens D. LundgrenAbstract:The epidemiology of HIV associated non-Hodgkin's lymphoma (NHL) was investigated in 6550 European patients with AIDS. NHL was diagnosed in 3.5% of all patients at the time of the AIDS Diagnosis. Although the probability of being diagnosed with NHL at AIDS Diagnosis was significantly higher among intravenous drug users than among homosexual men, and was associated with increasing age, the observed incidences of NHL were more strikingly similar than any differences. The rate of developing NHL after a previous AIDS Diagnosis was 2.4 per 100 patient years of follow-up, and remained constant during a 5-year follow-up period. While primary brain lymphomas comprised only 9% of NHL diagnosed at the time of AIDS, they comprised 38% of NHL diagnosed after AIDS (p < 0.001). The prognosis for patients with NHL at AIDS Diagnosis was poor with a median survival of 5 months. A Diagnosis of primary brain lymphoma was uniformly associated with a poor outcome. It is concluded that the probability of developing NHL in late stage HIV infection is lower than previously anticipated from the results of small studies on patients receiving long-term anti-retroviral therapy.
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Influence of Age on Rates of New AIDS-defining Diseases and Survival in 6546 AIDS Patients
Scandinavian journal of infectious diseases, 1997Co-Authors: Ulla Balslev, Court Pedersen, Andrew N. Phillips, Antonella D'arminio Monforte, George S. Stergiou, F Antunes, Fiona Mulcahy, Per Olav Pehrson, Jens D. LundgrenAbstract:It has consistently been reported that older AIDS patients have a shortened survival compared with younger patients. The aim of the present study was to investigate whether this difference in survival is caused by differences in the pattern of the complicating diseases. Information on patient follow-up after the AIDS Diagnosis was obtained by retrospective case note review. The 6,546 patients were followed from the time of AIDS Diagnosis as part of the multicentre AIDS in Europe study, which examined AIDS cases diagnosed at 52 centres in 17 European countries between 1979 and 1989. Occurrence of AIDS-defining events and demographic variables were recorded for all patients, and CD4 lymphocyte count at the time of AIDS Diagnosis for approximately half the patients. After adjusting for imbalances in other variables, persons ≥50 years of age had a significantly higher risk of contracting AIDS wasting syndrome, AIDS dementia complex and oesophageal candidiasis after the initial AIDS Diagnosis, compared with ag...
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Epidemiology of cryptosporidiosis among European AIDS patients.
Sexually Transmitted Infections, 1996Co-Authors: Court Pedersen, Sven A. Danner, Adriano Lazzarin, Michel P. Glauser, Rainer Weber, Christine Katlama, S. Barton, Jens D. LundgrenAbstract:OBJECTIVE: To study epidemiology and possible risk factors associated with the development of cryptosporidiosis among European patients with AIDS. METHODS: An inception cohort of 6548 patients with AIDS, consecutively diagnosed from 1979 to 1989, from 52 centres in 17 European countries was studied. Data on all AIDS defining events were collected retrospectively from patients9 clinical records. Kaplan-Meier estimates, log rank tests and Cox proportional hazard models were used to examine for possible risk factors associated with cryptosporidiosis. RESULTS: Cryptosporidiosis was diagnosed in 432 (6.6%) patients, 216 at time of the AIDS Diagnosis and 216 during follow-up. The probability of being diagnosed with cryptosporidiosis at AIDS Diagnosis was significantly lower for intravenous drug users (1.3%) than for homosexual men (4.1%) and for patients belonging to other transmission categories (4.0%) (p
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Epidemiology of AIDS Dementia Complex in Europe
Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association, 1996Co-Authors: Antonio Chiesi, Court Pedersen, Sven A. Danner, Michel P. Glauser, Stefano Vella, L. G. Dally, Anne M Johnson, S. Schwander, Frank-d. Goebel, Francisco AntunesAbstract:The aim of the study was to describe the epidemiology of AIDS dementia complex (ADC) in Europe and to assess the possible role of zidovudine therapy in preventing or delaying its occurrence. We used an inception cohort, with data collected retrospectively from patients' clinical records from 52 clinical centers in 17 countries across Europe. The subjects were 6,548 adult people with AIDS consecutively diagnosed from 1979 to 1989. The main outcome measures were coDiagnosis of ADC at the time of AIDS Diagnosis and ADC-free time after AIDS Diagnosis. ADC was reported in 295 patients (4.5%) at the time of AIDS Diagnosis and during follow-up in a further 402 of the 5,160 patients (7.8%) who were diagnosed with AIDS based on diseases other than ADC. Whether at the time of AIDS Diagnosis or later, the occurrence of ADC was significantly associated with age, transmission category, and CD4+ cell counts. The risk was greater in older patients (14 and 19% greater, at AIDS Diagnosis and after, respectively, for a 5-year difference in age), in i.v. drug users than in homosexual and bisexual men (89 and 60% greater, at AIDS Diagnosis and after, respectively), and for people with lower CD4+ cell counts (14 and 30% greater for a reduction of 1 on the natural log scale). Risk was almost double for women than for men. A significant reduction, of approximately 40%, was found in the risk of developing ADC after AIDS Diagnosis for patients receiving zidovudine therapy, but this effect was present only during the first 18 months of treatment, irrespective of whether treatment began before or after AIDS Diagnosis. In conclusion, an increase in the risk of developing ADC either at the time of AIDS Diagnosis or thereafter is associated with increasing age, i.v. drug use, and decreased CD4+ cell count. Women tend to have a higher risk of ADC at the time of AIDS Diagnosis. Zidovudine therapy appears to have a definite, but time-limited, effect of protecting patients against ADC development after AIDS Diagnosis.
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Factors Associated with the CD4' Lymphocyte Count at Diagnosis of Acquired Immunodeficiency Syndrome
Journal of clinical epidemiology, 1996Co-Authors: Andrew N. Phillips, Jens D. Lundgren, Court Pedersen, Adriano Lazzarin, Michel P. Glauser, Juan Gonzales-lahoz, Nathan Clumeck, Rui Proenca, Dénes Bánhegyi, Anne M JohnsonAbstract:To assess which factors are associated with the CD4+ lymphocyte count at the time of AIDS Diagnosis we studied 3046 patients in the AIDS IN EUROPE study who were diagnosed with AIDS in 1 of 17 European countries between 1979 and 1989 and for whom the CD4 count at AIDS Diagnosis was known. Data were extracted retrospectively from patient case notes, using a standardized form. There was a wide range of average CD4+ lymphocyte counts at AIDS Diagnosis, according to which diseases were present at Diagnosis. The highest geometric mean CD4+ lymphocyte counts at AIDS Diagnosis were associated with the Diagnosis of extrapulmonary tuberculosis, Kaposi's sarcoma, and non-Hodgkin's lymphoma while the lowest counts were found when histoplasmosis and cytomegalovirus (CMV) retinitis were present. There were no appreciable differences between CD4+ lymphocyte counts at AIDS in patients according to the three major transmission route categories (sex, age, or region of Diagnosis) but there was a marked trend (p < 0.005) toward lower CD4+ lymphocyte counts at AIDS Diagnosis in more recent years. These associations remained largely unchanged after adjustment for other factors.
Dawn Sudduth - One of the best experts on this subject based on the ideXlab platform.
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Spatial visualization of multivariate datasets: an analysis of STD and HIV/AIDS Diagnosis rates and socioeconomic context using ring maps.
Public health reports (Washington D.C. : 1974), 2011Co-Authors: Ana Lòpez-de Fede, John E Stewart, James W Hardin, Kathy Mayfield-smith, Dawn SudduthAbstract:We used existing data systems to examine sexually transmitted disease (STD) and HIV/AIDS Diagnosis rates and explore potential county-level associations between HIV/AIDS Diagnosis rates and socioeconomic disadvantage. Using South Carolina county data, we constructed multivariate ring maps to spatially visualize syphilis, gonorrhea, chlamydia, and HIV/AIDS Diagnosis rates; gender- and race-specific HIV/AIDS Diagnosis rates; and three measures of socioeconomic disadvantage-an unemployment index, a poverty index, and the Townsend index of social deprivation. Statistical analyses were performed to quantitatively assess potential county-level associations between HIV/AIDS Diagnosis rates and each of the three indexes of socioeconomic disadvantage. Ring maps revealed substantial spatial association in STD and HIV/AIDS Diagnosis rates and highlighted large gender and racial disparities in HIV/AIDS across the state. The mean county-level HIV/AIDS Diagnosis rate (per 100,000 population) was 24.2 for males vs. 11.2 for females, and 34.8 for African Americans vs. 5.2 for white people. In addition, ring map visualization suggested a county-level association between HIV/AIDS Diagnosis rates and socioeconomic disadvantage. Significant positive bivariate relationships were found between HIV/AIDS rate categories and each increase in poverty index category (odds ratio [OR] = 2.03; p=0.006), as well as each increase in Townsend index of social deprivation category (OR=4.98; p<0.001). A multivariate ordered logistic regression model in which all three socioeconomic disadvantage indexes were included showed a significant positive association between HIV/AIDS and Townsend index categories (adjusted OR=6.10; p<0.001). Ring maps graphically depicted the spatial coincidence of STD and HIV/AIDS and revealed large gender and racial disparities in HIV/AIDS across South Carolina counties. This spatial visualization method used existing data systems to highlight the importance of social determinants of health in program planning and decision-making processes.
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Spatial visualization of multivariate datasets: an analysis of STD and HIV/AIDS Diagnosis rates and socioeconomic context using ring maps.
Public Health Reports, 2011Co-Authors: Ana Lòpez-de Fede, John E Stewart, James W Hardin, Kathy Mayfield-smith, Dawn SudduthAbstract:Rates of sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) persist at elevated levels in the United States.1,2 Moreover, significant gender and racial/ethnic disparities in STD and HIV/AIDS rates remain, despite a commitment by public health leaders and the Healthy People 2010 initiative to eliminate health disparities.3 For example, the rate of primary- and secondary-stage syphilis (reported cases) is higher for men (7.8 per 100,000 population) than for women (1.4 per 100,000 population),2 while the rate of HIV diagnoses is higher among African Americans (66.6 per 100,000 population) than among white people (7.2 per 100,000 population).1 In accordance with program guidelines established by the Centers for Disease Control and Prevention (CDC), efforts to reduce STD and HIV/AIDS transmission and to address gender and racial/ethnic disparities in disease rates should be data driven.4–8 Disease surveillance data alone do not provide the contextual information necessary to guide the development of meaningful community interventions. Rather, successful STD and HIV/AIDS program planning and evaluation require the compilation, prioritization, and synthesis of wide-ranging information sets, including data on disease rates,1,2,5 modes of transmission,9–11 comorbid conditions,12–16 and treatment options and efficacy.13,16–18 Data on risk-taking behaviors;19–23 health-care-seeking and compliance behaviors;22,24–27 and sociocultural attitudes toward sex, STDs, and HIV/AIDS also are relevant to STD and HIV/AIDS programming efforts.9,20,28,29 Moreover, a growing body of literature cites a positive association between local disease rates and levels of socioeconomic disadvantage. For example, higher rates of syphilis, gonorrhea, and chlamydia have been found in impoverished areas of Massachusetts and Rhode Island;30 higher rates of AIDS have been noted in low-income neighborhoods in Los Angeles County in California31 and in census-block groups characterized by high levels of poverty in Massachusetts;32 and higher rates of HIV have been reported in high-poverty census tracts in Virginia.33 Based on such evidence, successful disease interventions must also consider the socioeconomic context of STDs and HIV/AIDS. Increasingly, geographic information systems (GISs) contribute critical spatial information to strengthen STD and HIV/AIDS program planning and evaluation processes.34–38 GIS visualization products—typically maps—yield valuable insight into relevant spatial distributions, patterns, and associations not readily apparent in tabled data. As useful as maps can be to STD/HIV/AIDS program planners and evaluators, the comparison and synthesis of information across multiple maps can prove cumbersome. A recent cartographic innovation, the ring map, facilitates the visual assessment of multivariate spatial data by depicting individual datasets as separate rings of information surrounding a base map of a particular geographic region of interest.39 In this way, a ring map effectively summarizes multiple layers of data, presenting an array of regional attributes (e.g., information about local population composition, health status, and/or socioeconomic conditions) in a single spatially referenced graphic. In this investigation, ring maps were created to spatially visualize county-level syphilis, gonorrhea, chlamydia, and HIV/AIDS Diagnosis rate data for South Carolina, a state that ranks third in the nation in chlamydia rates per 100,000 women2 and seventh in the rate of HIV diagnoses (ninth overall, including Puerto Rico and the U.S. Virgin Islands).1 In addition, a ring map was developed to visually explore potential county-level associations between HIV/AIDS Diagnosis rates and socioeconomic disadvantage in South Carolina.
