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Background: Mapping followed by critical inspection may help identify existing spatial patterns and relationships. Thus, it is a way to evaluate the location of services in relation to demand and need.
Objectives: To demonstrate the application of GIS methods to visually assess the spatial relationship between STD service supply (i.e., location of STD and family planning clinics) and demand (morbidity).
Methods: We overlaid geocoded STD and family planning clinics (identified by the Texas STD program and Title X funded family planning clinics) on mapped 2007 county-level reported STD incidence data from the National Electronic Telecommunications System for Surveillance and conducted a critical visual inspection of the resulting maps.
Results: Most high incidence counties had at least one STD clinic or family planning site within their borders. Our maps show that 25% (14/57) of Chlamydia high morbidity counties (>354/100,000) had neither an STD clinic nor a family planning site. Among the counties without these services, 14% (2/14) had no clinics in any of the adjacent counties. By comparison, 20% (4/20) of syphilis high morbidity counties (≥ 4/100,000 and at least 2 cases) had neither clinic type; while all these counties had some type of clinic in an adjacent county, 25% (1/4) had no STD clinic in an adjacent county.
Conclusions: Our study demonstrates the potential use of GIS by STD programs to assess location of services, morbidity, and partner management opportunities. Nonetheless, more work needs to be done to control for out-of-pocket costs, population density, and other county-level characteristics to better interpret the results.
Implications for Programs, Policy, and/or Research: Assessing if appropriate services are available in areas with high prevalence of STDs is important to ensure services are meeting demand. GIS methods can assist state and local STD programs in planning STD services and interventions to meet demand and monitor STD service delivery.