Aids

The geography of acquired immunodeficiency syndrome (AIDS) encompasses a number of spatial approaches to understanding the epidemic. More recent geographic studies of AIDS have focused less on the virus and macro diffusion patterns and more on the human geographies of risk and experience of AIDS. One category of investigation focuses on regionally specific contexts of human immunodeficiency virus (HIV) vulnerability. In these studies, social, economic, political, and cultural practices at multiple spatial scales are examined for their impact on individuals' vulnerability to HIV in particular regional locations. These place-specific investigations are critical to understanding micro patterns of transmission given the substantial evidence that factors driving transmission of HIV in one place do not necessarily explain transmission patterns and levels in another place. Clearer understandings of what makes people engage in risky behaviors and become vulnerable to HIV is, in turn, pivotal in implementing more effective prevention and treatment strategies.

Examining geographies of everyday life with HIV/AIDS constitutes another important part of a geography of AIDS. How and whether persons living with HIV and AIDS (PLWHAs) are able to access healthcare and other services are critical to providing the best treatment possible. Earlier geographic studies focused on mapping residence patterns with location of clinics and other services, but more recent studies have recognized that access is more complicated and includes, among other things, individuals' social networks, the degree of flexibility in the workplace, how much stigma individuals face in their lives, income levels, child care responsibilities, and quality of care[Page 8] available. Other work has looked at the ways in which PLWHAs cope with reduced spaces and places in which they live their lives. This can be because stigma works to block access to particular places such as housing, jobs, countries, and individuals' homes or because deteriorating physical status reduces mobility. The ways in which people experience space and place when coping with AIDS are vital to implementing better outreach programs and services.

Earlier geographic studies of AIDS focused on the virus itself, investigating theories of HIV's origins and transmission patterns. Many scientists and social scientists thought that determining sites of the first HIV cases would assist in understanding where, when, and how HIV subsequently spread to the rest of the world. Much geography of AIDS during the 1980s consequently focused on mapping spatial routes of transmission over time, tracing likely patterns of HIV diffusion across continents using data of first known cases in each region together with travel and migration routes. Although none of these patterns was conclusive, they provided models for illuminating continued transmission of HIV as well as likely points of intervention. Critics of origin theories, however, contended that finding origins does little to understand current patterns of HIV transmission and instead generates negative consequences such as blame for causing a deadly epidemic. Focusing on large-scale geographic patterns also did little to further understanding about the complex network of behaviors and practices underlying transmission of HIV.